Literature DB >> 22300933

Quality control in neuroradiology: impact of trainees on discrepancy rates.

V G Viertel1, L S Babiarz, M Carone, J S Lewin, D M Yousem.   

Abstract

BACKGROUND AND
PURPOSE: Prior studies have found a 2%-8% clinically significant error rate in radiology practice. We compared discrepancy rates of studies interpreted by subspecialty-trained neuroradiologists working with and without trainees.
MATERIALS AND METHODS: Subspecialty-trained neuroradiologists reviewed 2162 studies during 41 months. Discrepancies between the original and "second opinion" reports were scored: 1, no change; 2, clinically insignificant detection discrepancy; 3, clinically insignificant interpretation discrepancy; 4, clinically significant detection discrepancy; and 5, clinically significant interpretation discrepancy. Faculty alone versus faculty and trainee discrepancy rates were calculated.
RESULTS: In 87.6% (1894/2162), there were no discrepancies with the original report. The neuroradiology division had a 1.8% (39/2162; 95% CI, 1.3%-2.5%) rate of clinically significant discrepancies. In cases reviewed solely by faculty neuroradiologists (16.2% = 350/2162 of the total), the rate of discrepancy was 1.7% (6/350). With fellows (1232/2162, 57.0% of total) and residents (580/2162, 26.8% of total), the rates of discrepancy were 1.6% (20/1232) and 2.2% (13/580), respectively. The odds of a discrepant result were 26% greater (OR = 1.26; 95% CI, 0.38-4.20) when reading with a resident and 8% less (OR = 0.92; 95% CI, 0.35-2.44) when reading with a fellow than when reading alone.
CONCLUSIONS: There was a 1.8% rate of clinically significant detection or interpretation discrepancy among academic neuroradiologists. The difference in the discrepancy rates between faculty only (1.7%), fellows and faculty (1.6%), and residents and faculty (2.2%) was not statistically significant but showed a trend indicating that reading with a resident increased the odds of a discrepant result.

Entities:  

Mesh:

Year:  2012        PMID: 22300933      PMCID: PMC4337866          DOI: 10.3174/ajnr.A2933

Source DB:  PubMed          Journal:  AJNR Am J Neuroradiol        ISSN: 0195-6108            Impact factor:   3.825


  18 in total

1.  Variation between experienced observers in the interpretation of accident and emergency radiographs.

Authors:  P J Robinson; D Wilson; A Coral; A Murphy; P Verow
Journal:  Br J Radiol       Date:  1999-04       Impact factor: 3.039

Review 2.  Accuracy of diagnostic tests read with and without clinical information: a systematic review.

Authors:  Clement T Loy; Les Irwig
Journal:  JAMA       Date:  2004-10-06       Impact factor: 56.272

3.  Quality control in neuroradiology: discrepancies in image interpretation among academic neuroradiologists.

Authors:  L S Babiarz; D M Yousem
Journal:  AJNR Am J Neuroradiol       Date:  2011-10-27       Impact factor: 3.825

4.  Accuracy of diagnostic procedures: has it improved over the past five decades?

Authors:  Leonard Berlin
Journal:  AJR Am J Roentgenol       Date:  2007-05       Impact factor: 3.959

5.  Disagreement in interpretation: a method for the development of benchmarks for quality assurance in imaging.

Authors:  David J Soffa; Rebecca S Lewis; Jonathan H Sunshine; Mythreyi Bhargavan
Journal:  J Am Coll Radiol       Date:  2004-03       Impact factor: 5.532

6.  Discrepancy rates of radiology resident interpretations of on-call neuroradiology MR imaging studies.

Authors:  Christopher G Filippi; Brett Schneider; Heather N Burbank; Gary F Alsofrom; Grant Linnell; Bela Ratkovits
Journal:  Radiology       Date:  2008-12       Impact factor: 11.105

7.  On the scientific evaluation of diagnostic procedures.

Authors:  L H GARLAND
Journal:  Radiology       Date:  1949-03       Impact factor: 11.105

8.  Lung lesions: correlation between viewing time and detection.

Authors:  J W Oestmann; R Greene; D C Kushner; P M Bourgouin; L Linetsky; H J Llewellyn
Journal:  Radiology       Date:  1988-02       Impact factor: 11.105

9.  Resident film interpretations and staff review.

Authors:  S E Seltzer; S J Hessel; P G Herman; R G Swensson; C R Sheriff
Journal:  AJR Am J Roentgenol       Date:  1981-07       Impact factor: 3.959

10.  Performance parameters for screening and diagnostic mammography: specialist and general radiologists.

Authors:  Edward A Sickles; Dulcy E Wolverton; Katherine E Dee
Journal:  Radiology       Date:  2002-09       Impact factor: 11.105

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  3 in total

Review 1.  Errors in neuroradiology.

Authors:  Ferdinando Caranci; Enrico Tedeschi; Giuseppe Leone; Alfonso Reginelli; Gianluca Gatta; Antonio Pinto; Ettore Squillaci; Francesco Briganti; Luca Brunese
Journal:  Radiol Med       Date:  2015-07-17       Impact factor: 3.469

2.  Comparing Preliminary and Final Neuroradiology Reports: What Factors Determine the Differences?

Authors:  K Stankiewicz; M Cohen; M Carone; G Sevinc; P G Nagy; J S Lewin; D M Yousem; L S Babiarz
Journal:  AJNR Am J Neuroradiol       Date:  2016-07-28       Impact factor: 3.825

3.  Diagnostic Errors in Cerebrovascular Pathology: Retrospective Analysis of a Neuroradiology Database at a Large Tertiary Academic Medical Center.

Authors:  G Biddle; R Assadsangabi; K Broadhead; L Hacein-Bey; V Ivanovic
Journal:  AJNR Am J Neuroradiol       Date:  2022-08-04       Impact factor: 4.966

  3 in total

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