Radiologic education2008 Joseph E. and Nancy Whitley Award recipientFactors Affecting Attending Agreement with Resident Early Readings of Computed Tomography and Magnetic Resonance Imaging of the Head, Neck, and Spine
Section snippets
Materials and methods
In March 2002, we instituted a quality assessment program to address radiology resident after-hours and weekend preliminary interpretation of neuroradiology computed tomography (CT) and magnetic resonance imaging (MRI) studies. This entailed a preprinted form attached to study requisitions that were completed by second through fourth year residents performing the initial reading (Fig. 1). These forms contained a text box for the resident to write their impression as well as spaces to denote
Results
There were 22,264 observations in the initial database query and after eliminating those for four residents with fewer than 200 entries, 21,796 remained, which were subsequently analyzed. These cases were preliminarily interpreted by 1 of 46 diagnostic radiology residents and reviewed by 1 of 9 attending neuroradiologists. Overall, there were 187 (0.86%) significant disagreements, 665 (3.05%) minimal disagreements, and 20,944 (96.09%) agreements. Figure 2 depicts a time series of the absolute
Discussion
Previous studies have addressed discrepancy rates between initial radiology resident and final attending interpretations of radiologic examinations. Most of the larger sample sizes have been achieved by characterizing and enumerating the disagreements (numerator) and then back-calculated percentages by counting the total number of cases (denominator) from other sources such as the radiology information system, Picture Archiving and Communication System, or dictation records (4, 5, 8, 9, 10, 11
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2020, Academic RadiologyCitation Excerpt :Neuroradiology cases were the most difficult to interpret correctly (p<0.0001) with effect size of 2.3 (95% CI 1.9–3.2) points lower than body and musculoskeletal oriented cases, which were not different from each other (p = 0.36). Multiple analyses by other investigators of resident-attending discrepancy reflect this trend with neuroradiology overnight readings having significantly higher rates compared to other sub-specialties (16–21). Case acuity had a significant effect (p<0.0001) on residence performance.
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2019, Academic RadiologyCitation Excerpt :It is likely some studies with major discordances, are not officially recorded by the attending radiologist and thus excluded from the calculation of the resident's discordance rate. Attending radiologist variability can therefore potentially affect resident discrepancy rates. (11,12,14). We also acknowledge that our measures of resident performance are imperfect.
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2018, Academic RadiologyCitation Excerpt :The discrepant management decisions or procedural techniques employed by residents of other specialties may not receive the same high profile persistence in the clinical record as those of radiology residents. Previous work has shown the attending to account for most of the variation in resident-attending discrepancies (23), thus an attempt was made to evaluate attending accuracy in their discrepancies. The attendings were correct 80.5% of the time when confirmatory testing was available, showing their supervision to be effective in improving study interpretation accuracy.
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2018, Academic RadiologyClinical Impact of Second-Opinion Musculoskeletal Subspecialty Interpretations During a Multidisciplinary Orthopedic Oncology Conference
2017, Journal of the American College of RadiologyCitation Excerpt :Given the radiology-wide pressures to improve efficiency, add clinical value, and curb imaging costs, the clinical impact of second-opinion consultation reads is an evolving question that warrants further investigation [6-10]. Previous investigators have published discrepancy rates between different radiologists, including musculoskeletal radiologists, ranging from 0.1% to 26% [6-22]. Only one study has addressed the clinical value of second-opinion orthopedic radiology consultations; however, the study was not specific to a medically complex orthopedic oncology patient population [12].