Abstract
.Frequently, the consensus conclusion after quality assurance conferences in radiology is that whatever mistake was made could have been avoided if more prior images or documents had been consulted. It is generally assumed that anything that was not specifically cited in the report had not been consulted. Is it actually safe to assume that an image or document that is not cited was also not consulted? It is this question that this investigation addresses. In this Institutional Review Board-approved study, one observer watched the board-certified radiologists while they interpreted imaging studies and issued reports. He recorded what type of study was being interpreted [either computed tomography, magnetic resonance imaging, or conventional radiography (x-ray)]. He also recorded the number and type of prior imaging studies and documents that were consulted during the interpretation. These observations were then compared with the signed report to determine how many of the consulted imaging studies and documents were cited. Of the 198 previous imaging studies that the radiologists consulted, 116 (58.6%) were cited in a report. Of the 285 documents consulted, 3 (1.1%) were cited in a report. This difference in citation rate was statistically significant (). It cannot be safely assumed that an older radiologic image or medical document was not consulted during radiologic interpretation merely because it is not cited in the report. Radiologists often consult more old studies than they cite, and they do not cite the majority of prior documents that they consult.
Highlights
In many quality assurance meetings in radiology, the consensus conclusion is that a mistake could have been avoided if more prior images or documents had been consulted
Kevin Berbaum and colleagues found that both the old images and the old reports were useful in helping radiologists reach a more specific conclusion from the images being interpreted and in increasing their confidence in that interpretation, but the old images were more helpful than the reports, with the old report being used mainly to provide patient history or the previous radiologist’s opinion.[3,4,5]
The others estimated an average of 75 computed tomography studies (CTs) interpreted per week, 19 magnetic resonance imaging (MRI) interpreted per week, and 21 conventional radiographs
Summary
In many quality assurance meetings in radiology, the consensus conclusion is that a mistake could have been avoided if more prior images or documents had been consulted. It is assumed that any previous study or document that was not cited in the report was not consulted. Is it safe to assume that an image or document that is not cited was not consulted? There is little available in the literature concerning use of written documents in formulating reports on current imaging studies. Most of this has focused on the use of the radiology report. Kevin Berbaum and colleagues found that both the old images and the old reports were useful in helping radiologists reach a more specific conclusion from the images being interpreted and in increasing their confidence in that interpretation, but the old images were more helpful than the reports, with the old report being used mainly to provide patient history or the previous radiologist’s opinion.[3,4,5] There can be a downside to
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