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Yield of Learning Opportunities From a Radiology Random Peer Review Program.
AJR Am J Roentgenol. 2018 09; 211(3):630-634.AA

Abstract

OBJECTIVE

The purpose of this study is to assess the yield and usage of a radiology random peer review program in identifying potentially meaningful discrepancies in radiology reports that could serve as learning opportunities.

MATERIALS AND METHODS

This retrospective study was performed at a 776-bed tertiary academic hospital that renders more than 620,000 radiology reports annually. A workstation-embedded peer review system was implemented on January 1, 2014, followed by radiologist training over the next 12 weeks. From April 1, 2014, through September 30, 2017 (14 quarters), randomly selected radiologic studies were peer reviewed and scored as follows: 1, agree with original interpretation; 2, minor discrepancy, not likely clinically significant; 3, moderate discrepancy, may be clinically significant; or 4, major discrepancy, likely clinically significant. Reports scored as 3 or 4 were defined as having potentially meaningful discrepancies, and the discrepancy type was characterized. The primary outcome was the quarterly rate of potentially meaningful discrepancies. The secondary outcome was program usage rate (number of reports peer reviewed / total reports generated). Chi-square trend test assessed changes in outcomes over time.

RESULTS

Of a total of 42,891 peer reviews performed, the overall potentially meaningful discrepancy rate (or yield) was 0.5% (233/42,891). The quarterly potentially meaningful discrepancy rate decreased significantly over the study period (p < 0.0001). The quarter 14 potentially meaningful discrepancy rate (0.003) was 70% lower than the quarter 1 rate (0.011). Quarterly program usage also decreased significantly over the study period (p < 0.0001). Quarter 14 usage (0.015) was 56% lower than quarter 1 usage (0.034). Among 184 potentially meaningful discrepancy reports that could be categorized, the most common discrepancy type was error of perception (87/184).

CONCLUSION

A workstation-embedded random radiology peer review program had a very low yield in identifying learning opportunities and declining usage over time.

Authors+Show Affiliations

1 Center for Evidence-Based Imaging, Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.1 Center for Evidence-Based Imaging, Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.1 Center for Evidence-Based Imaging, Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30016146

Citation

Trinh, Tony W., et al. "Yield of Learning Opportunities From a Radiology Random Peer Review Program." AJR. American Journal of Roentgenology, vol. 211, no. 3, 2018, pp. 630-634.
Trinh TW, Shinagare AB, Khorasani R. Yield of Learning Opportunities From a Radiology Random Peer Review Program. AJR Am J Roentgenol. 2018;211(3):630-634.
Trinh, T. W., Shinagare, A. B., & Khorasani, R. (2018). Yield of Learning Opportunities From a Radiology Random Peer Review Program. AJR. American Journal of Roentgenology, 211(3), 630-634. https://doi.org/10.2214/AJR.17.19373
Trinh TW, Shinagare AB, Khorasani R. Yield of Learning Opportunities From a Radiology Random Peer Review Program. AJR Am J Roentgenol. 2018;211(3):630-634. PubMed PMID: 30016146.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Yield of Learning Opportunities From a Radiology Random Peer Review Program. AU - Trinh,Tony W, AU - Shinagare,Atul B, AU - Khorasani,Ramin, Y1 - 2018/07/17/ PY - 2018/7/18/pubmed PY - 2019/6/14/medline PY - 2018/7/18/entrez KW - diagnostic errors KW - learning opportunities KW - peer feedback KW - peer learning KW - peer review SP - 630 EP - 634 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 211 IS - 3 N2 - OBJECTIVE: The purpose of this study is to assess the yield and usage of a radiology random peer review program in identifying potentially meaningful discrepancies in radiology reports that could serve as learning opportunities. MATERIALS AND METHODS: This retrospective study was performed at a 776-bed tertiary academic hospital that renders more than 620,000 radiology reports annually. A workstation-embedded peer review system was implemented on January 1, 2014, followed by radiologist training over the next 12 weeks. From April 1, 2014, through September 30, 2017 (14 quarters), randomly selected radiologic studies were peer reviewed and scored as follows: 1, agree with original interpretation; 2, minor discrepancy, not likely clinically significant; 3, moderate discrepancy, may be clinically significant; or 4, major discrepancy, likely clinically significant. Reports scored as 3 or 4 were defined as having potentially meaningful discrepancies, and the discrepancy type was characterized. The primary outcome was the quarterly rate of potentially meaningful discrepancies. The secondary outcome was program usage rate (number of reports peer reviewed / total reports generated). Chi-square trend test assessed changes in outcomes over time. RESULTS: Of a total of 42,891 peer reviews performed, the overall potentially meaningful discrepancy rate (or yield) was 0.5% (233/42,891). The quarterly potentially meaningful discrepancy rate decreased significantly over the study period (p < 0.0001). The quarter 14 potentially meaningful discrepancy rate (0.003) was 70% lower than the quarter 1 rate (0.011). Quarterly program usage also decreased significantly over the study period (p < 0.0001). Quarter 14 usage (0.015) was 56% lower than quarter 1 usage (0.034). Among 184 potentially meaningful discrepancy reports that could be categorized, the most common discrepancy type was error of perception (87/184). CONCLUSION: A workstation-embedded random radiology peer review program had a very low yield in identifying learning opportunities and declining usage over time. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/30016146/Yield_of_Learning_Opportunities_From_a_Radiology_Random_Peer_Review_Program_ L2 - https://www.ajronline.org/doi/10.2214/AJR.17.19373 DB - PRIME DP - Unbound Medicine ER -