Document Detail


Discrepancy rates of on-call radiology residents' interpretations of CT angiography studies of the neck and circle of Willis.
MedLine Citation:
PMID:  19620452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of our study was to determine the discrepancy rates of radiology residents' interpretations of emergent CT angiography (CTA) studies of the neck and circle of Willis and to assess any adverse clinical outcomes. MATERIALS AND METHODS: Five hundred thirty-eight CTA studies (287 circle of Willis and 251 neck) ordered emergently after hours and given preliminary readings by radiology residents from January 1, 2006, through December 31, 2007, were retrospectively reviewed. Discrepancies between the interpretations of radiology residents and the final reports of neuroradiology attending physicians were classified as either false-negatives (failure to recognize abnormalities) or false-positives (misinterpreting normal scans as abnormal). Discrepancies that could affect patient care or clinical care were considered major. RESULTS: Overall, the discrepancy rate was 13.6% for circle of Willis CTA and 13.5% for neck CTA. The misinterpretation rate of first-year residents was 19.5%, which was statistically significant compared with more senior-level residents (p = 0.05). There were 57 false-negative interpretations. The most common misses were stenosis greater than 50% (n = 16) and aneurysm (n = 15), and the most common false-positive was overcalling a potential intracranial aneurysm (n = 7). No adverse clinical outcomes were detected. CONCLUSION: The discrepancy rate between interpretations by on-call radiology residents and attending physicians of neuroradiology CTA studies was higher than expected at 13.6%, with a statistically significant greater miss rate among the most junior residents, which may be mitigated by recent changes with respect to the radiology residents' overnight call. No adverse clinical outcome was detected.
Authors:
Russell E Meyer; Joshua P Nickerson; Heather N Burbank; Gary F Alsofrom; Grant J Linnell; Christopher G Filippi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  193     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-21     Completed Date:  2009-09-08     Revised Date:  2010-03-02    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  527-32     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Fletcher Allen Health Care, University of Vermont School of Medicine, 111 Colchester Ave., Burlington, VT 05401, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography / methods*
Carotid Stenosis / radiography
Circle of Willis / radiography*
Diagnostic Errors / statistics & numerical data*
False Positive Reactions
Female
Humans
Internship and Residency / statistics & numerical data*
Male
Middle Aged
Neck / radiography*
Radiology / education*
Reproducibility of Results
Retrospective Studies
Stroke / radiography
Tomography, X-Ray Computed / methods
Vascular Diseases / radiography*
Vermont
Comments/Corrections
Comment In:
AJR Am J Roentgenol. 2010 Mar;194(3):W282   [PMID:  20173127 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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