HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Carney, E. Articles by Nosher, J. Search for Related Content PubMed PubMed Citation Articles by Carney, E. Articles by Nosher, J. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Preliminary Interpretations of After-Hours CT and Sonography by Radiology Residents Versus Final Interpretations by Body Imaging Radiologists at a Level 1 Trauma Center

¹ All authors: Department of Radiology, Robert Wood Johnson University Hospital, 1 Robert Wood Johnson Pl., MEB 4th Fl., New Brunswick, NJ 08901.

OBJECTIVE. At many academic institutions, preliminary interpretations of CT scans and sonograms obtained after regular hours of operation are performed by radiology residents, with attending radiologists reviewing the interpretations the next morning. We sought to determine the rate of discrepancy between residents' interpretations of imaging studies and the final interpretations performed by an attending body imaging radiologist as well as any resulting clinical consequences stemming from the discrepancies. Therefore, we reviewed 928 CT and sonographic images that had been obtained after hours at a level 1 trauma center during a 6-month period.

MATERIALS AND METHODS. Any discrepancies between the preliminary and final interpretations were judged as either major (i.e., necessitating an urgent change in treatment) or minor errors. We conducted patient follow-up via a retrospective review of the medical charts to determine whether any of the discrepancies led to additional imaging, an increase in patient morbidity, an extension of a hospital stay, or a change in treatment.

RESULTS. The overall discrepancy rate in interpretations rendered by the residents and those performed by the attending radiologist was 3.8%, with most of these discrepancies (86%) judged to be minor. If we combined the data for body CT scans and sonograms, the rate of minor discrepancies was 3.2%, and the rate of major discrepancies was 0.5%. If we considered only body CT data in the evaluation, the overall discrepancy rate increased to 6.4%, with a 5.4% rate of minor discrepancies and a 1.0% rate of major discrepancies.

CONCLUSION. Our evaluation of discrepancy rates was unusual in that we included interpretations of sonograms, on which residents and the attending radiologist had a higher rate of agreement (99.5%). Because of the high agreement in the interpretation of sonograms, the overall discrepancy rate was 3.8%. However, if only body CT scan interpretations were evaluated, our results were closer to the rates reported in previously published studies. Major discrepancies led to a change in patient treatment but did not lead to any increase in patient morbidity or to any quantifiable increase in the length of the hospital stay.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C. G. Filippi, B. Schneider, H. N. Burbank, G. F. Alsofrom, G. Linnell, and B. Ratkovits Discrepancy Rates of Radiology Resident Interpretations of On-Call Neuroradiology MR Imaging Studies Radiology, December 1, 2008; 249(3): 972 - 979. [Abstract] [Full Text] [PDF]

				W.M. Strub, J.L. Leach, T. Tomsick, and A. Vagal Overnight Preliminary Head CT Interpretations Provided by Residents: Locations of Misidentified Intracranial Hemorrhage AJNR Am. J. Neuroradiol., October 1, 2007; 28(9): 1679 - 1682. [Abstract] [Full Text] [PDF]

				R. B. Ruchman, J. Jaeger, E. F. Wiggins III, S. Seinfeld, V. Thakral, S. Bolla, and S. Wallach Preliminary Radiology Resident Interpretations Versus Final Attending Radiologist Interpretations and the Impact on Patient Care in a Community Hospital Am. J. Roentgenol., September 1, 2007; 189(3): 523 - 526. [Abstract] [Full Text] [PDF]