J Korean Soc Emerg Med.  2008 Apr;19(2):205-210.

Overnight Preliminary Interpretations of CT and MR Images by Radiology Residents in ER: How Accurate Are They?

• Jin KN
• Jae HJ
• Shin CI
• Chai JW
• Chun SR
• Shin SD
• Kang YJ
• Na DK

Abstract

PURPOSE: At many institutes in Korea, preliminary interpretations of after-hours CT and MR images are performed by radiology residents, with the attending radiologist's reviewing the interpretations the next day. The purpose of this study was to assess the rate of discrepancy between residents' interpretations and the final interpretations performed by attending radiologists.
METHODS
We reviewed the interpretations of 1381 CT and 404 MRI scans that were obtained at the emergency department of our institute over three months. Any discrepancies between the preliminary and final interpretations were categorized as either major or minor discrepancies with a major discrepancy defined as one resulting in a change in diagnosis and treatment plans. We conducted patient follow-up via a retrospective review of the medical records to evaluate the clinical outcomes of the discrepancies.
RESULTS
The rate of major discrepancies was 2.5%, and the rate of minor discrepancies was 11.4%. Major discrepancies led to a change in diagnosis or patient treatment plans, but did not lead to any increase in patient morbidity.
CONCLUSION
The discrepancy rate at our institution was relatively insignificant, and patient care at the emergency department was not adversely affected by having radiology residents interpret CT and MRI scans after-hours and the attending radiologist review the interpretations the next morning. Still, further efforts are needed in order to reduce the frequency of major discrepancies.

Keyword

Radiology; Emergency Medicine; Internship and Residency; Diagnostic Variation; Magnetic Resonance Imaging Tomography; X-Ray; Computed

MeSH Terms

Academies and Institutes
Emergencies
Emergency Medicine
Follow-Up Studies
Humans
Internship and Residency
Korea
Magnetic Resonance Imaging
Medical Records
Patient Care
Retrospective Studies