Rajan Arora1, Nirupama Kannikeswaran. 1. From the Division of Pediatric Emergency Medicine Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI.
Abstract
BACKGROUND: Clinical impact of radiology callbacks (missed initial radiologic diagnosis) remains largely unknown in the pediatric emergency department (PED). OBJECTIVE: The aim of this study was to describe the incidence, nature of radiology callbacks, and the impact on clinical care during the return visit (RV). METHODS: We performed a retrospective chart review of quality assurance database of RVs for radiology callbacks to our PED over a 1-year period. RESULTS: Return visit rate to our PED was 3% (2765/92,000) of which 1.9% (55/2765) was for radiology callbacks. Radiology misses involved mostly x-ray interpretations (92.7%), occurred after-hours (83.6%), with fractures being the most common missed finding. Majority of patients (94.5%) required 1 or more interventions during the RV; 34.5% of radiology callbacks had a major impact on clinical management; 27.2% of radiology callbacks were false-positive. CONCLUSIONS: Although RVs secondary to radiology callback remain low, one third of them resulted in major changes in diagnosis, treatment, or disposition and impacted patient outcome.
BACKGROUND: Clinical impact of radiology callbacks (missed initial radiologic diagnosis) remains largely unknown in the pediatric emergency department (PED). OBJECTIVE: The aim of this study was to describe the incidence, nature of radiology callbacks, and the impact on clinical care during the return visit (RV). METHODS: We performed a retrospective chart review of quality assurance database of RVs for radiology callbacks to our PED over a 1-year period. RESULTS: Return visit rate to our PED was 3% (2765/92,000) of which 1.9% (55/2765) was for radiology callbacks. Radiology misses involved mostly x-ray interpretations (92.7%), occurred after-hours (83.6%), with fractures being the most common missed finding. Majority of patients (94.5%) required 1 or more interventions during the RV; 34.5% of radiology callbacks had a major impact on clinical management; 27.2% of radiology callbacks were false-positive. CONCLUSIONS: Although RVs secondary to radiology callback remain low, one third of them resulted in major changes in diagnosis, treatment, or disposition and impacted patient outcome.
Authors: Laura Mattijssen-Horstink; Judith Joëlle Langeraar; Gert Jan Mauritz; William van der Stappen; Maarten Baggelaar; Edward Camillus Thwan Han Tan Journal: Scand J Trauma Resusc Emerg Med Date: 2020-05-13 Impact factor: 2.953