Abstract
Prior studies have found a 3%-6% clinically significant error rate in radiology practice. We set out to assess discrepancy rates between subspecialty-trained university-based neuroradiologists. Over 17 months, university neuroradiologists randomly reviewed 1000 studies and reports of previously read examinations of patients in whom follow-up studies were read. The discrepancies between the original and "second opinion" reports were scored according to a 5-point scale: 1, no change; 2, clinically insignificant detection discrepancy; 3, clinically insignificant interpretation discrepancy; 4, clinically significant detection discrepancy; and 5, clinically significant interpretation discrepancy. Of the 1000 studies, 876 (87.6%) showed agreements with the original report. The neuroradiology division had a 2.0% (20/1000; 95% CI, 1.1%-2.9%) rate of clinically significant discrepancies involving 8 CTs and 12 MR images. Discrepancies were classified as vascular (n = 7), neoplastic (n = 9), congenital (n = 2), and artifacts (n = 2). Individual neuroradiologist's scores ranged from 0% to 7.7% ± 2.3% (n = 18). Both CT and MR imaging studies had a discrepancy rate of 2.0%. Our quality assessment study could serve as initial data before intervention as part of a PQI project.
Highlights
Given that a large portion of the neuroradiologists were trained at the same home institution and may have had similar interpretation tendencies and biases, we looked at the difference in discrepancy rates between the neuroradiologists trained at the home and at other institutions
One thousand neuroradiology studies originally read by 18 neuroradiologists were reread by the 11 neuroradiologists currently on staff
We found a 2.0% rate of clinically significant detection or interpretation discrepancy between the original report and the second opinion review for the whole neuroradiology division
Summary
Our goal was to devise a practical and efficient quality assurance program that enhances the daily workflow by encouraging faculty to review prior reports
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