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Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital.
AJR Am J Roentgenol. 2007 Sep; 189(3):523-6.AA

Abstract

OBJECTIVE

At academic institutions, overnight emergency radiology examinations are interpreted by the on-call radiology resident and are reviewed by an attending radiologist in the morning. The objective of our study was to determine the rate of discrepancies between the two interpretations and the possible effect, if any, on patient care.

MATERIALS AND METHODS

The preliminary reports for 11,908 emergency diagnostic imaging examinations interpreted after hours by residents over a 3-year period (January 2002-January 2005) were reviewed retrospectively for any discrepancy with the attending radiologist's final interpretation. A discrepancy was noted if verbal notification of the ordering physician was required. The medical charts of the cases for which there was a major discrepancy between the two interpretations were reviewed. The discrepancies were categorized as to the effect on patient morbidity. The resident discrepancy rates were also compared with RADPEER data from our institution.

RESULTS

The overall major discrepancy rate was 2.6%. This rate is comparable to RADPEER data, which found a misinterpretation rate of 2.1%. The technique most commonly involved in cases with discrepant interpretations was contrast-enhanced CT of the abdomen and pelvis, with the most common diagnosis related to acute appendicitis (total of 21 cases). The rate of discrepancy was highest for residents who were in their third year of training. The indications for these examinations varied; however, the effect on patient management was no significant effect in 92.8%, some negative effect in 6.9%, and significant negative effect in 0.3%.

CONCLUSION

The results of this investigation highlight the minimal discrepancy rate that occurs with overnight resident coverage. Thus, there is no detrimental effect on the quality of patient care from relying on preliminary interpretations made by radiology residents.

Authors+Show Affiliations

Department of Radiology, Monmouth Medical Center, 300 Second Ave., Long Branch, NJ 07740, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17715095

Citation

Ruchman, Richard B., et al. "Preliminary Radiology Resident Interpretations Versus Final Attending Radiologist Interpretations and the Impact On Patient Care in a Community Hospital." AJR. American Journal of Roentgenology, vol. 189, no. 3, 2007, pp. 523-6.
Ruchman RB, Jaeger J, Wiggins EF, et al. Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital. AJR Am J Roentgenol. 2007;189(3):523-6.
Ruchman, R. B., Jaeger, J., Wiggins, E. F., Seinfeld, S., Thakral, V., Bolla, S., & Wallach, S. (2007). Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital. AJR. American Journal of Roentgenology, 189(3), 523-6.
Ruchman RB, et al. Preliminary Radiology Resident Interpretations Versus Final Attending Radiologist Interpretations and the Impact On Patient Care in a Community Hospital. AJR Am J Roentgenol. 2007;189(3):523-6. PubMed PMID: 17715095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital. AU - Ruchman,Richard B, AU - Jaeger,Joseph, AU - Wiggins,Ernest F,3rd AU - Seinfeld,Syndi, AU - Thakral,Vikas, AU - Bolla,Sudha, AU - Wallach,Sara, PY - 2007/8/24/pubmed PY - 2007/9/19/medline PY - 2007/8/24/entrez SP - 523 EP - 6 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 189 IS - 3 N2 - OBJECTIVE: At academic institutions, overnight emergency radiology examinations are interpreted by the on-call radiology resident and are reviewed by an attending radiologist in the morning. The objective of our study was to determine the rate of discrepancies between the two interpretations and the possible effect, if any, on patient care. MATERIALS AND METHODS: The preliminary reports for 11,908 emergency diagnostic imaging examinations interpreted after hours by residents over a 3-year period (January 2002-January 2005) were reviewed retrospectively for any discrepancy with the attending radiologist's final interpretation. A discrepancy was noted if verbal notification of the ordering physician was required. The medical charts of the cases for which there was a major discrepancy between the two interpretations were reviewed. The discrepancies were categorized as to the effect on patient morbidity. The resident discrepancy rates were also compared with RADPEER data from our institution. RESULTS: The overall major discrepancy rate was 2.6%. This rate is comparable to RADPEER data, which found a misinterpretation rate of 2.1%. The technique most commonly involved in cases with discrepant interpretations was contrast-enhanced CT of the abdomen and pelvis, with the most common diagnosis related to acute appendicitis (total of 21 cases). The rate of discrepancy was highest for residents who were in their third year of training. The indications for these examinations varied; however, the effect on patient management was no significant effect in 92.8%, some negative effect in 6.9%, and significant negative effect in 0.3%. CONCLUSION: The results of this investigation highlight the minimal discrepancy rate that occurs with overnight resident coverage. Thus, there is no detrimental effect on the quality of patient care from relying on preliminary interpretations made by radiology residents. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/17715095/Preliminary_radiology_resident_interpretations_versus_final_attending_radiologist_interpretations_and_the_impact_on_patient_care_in_a_community_hospital_ L2 - https://www.ajronline.org/doi/10.2214/AJR.07.2307 DB - PRIME DP - Unbound Medicine ER -