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

Jin,  Kwang Nam; Jae,  Hwan Jun; Shin,  Cheong Il; Chai,  Ji Won; Chun,  Su Ryung; Shin,  Sang Do; Kang,  Young Joon; Na,  Dong Kyu

J Korean Soc Emerg Med > Volume 19(2); 2008 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2008;19(2): 205-210.

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

Kwang Nam Jin, Hwan Jun Jae, Cheong Il Shin, Ji Won Chai, Su Ryung Chun, Sang Do Shin, Young Joon Kang, Dong Kyu Na

¹Department of Radiology, Seoul National University Hospital, Korea.
²Department of Emergency Medicine, Seoul National University Hospital, Korea. aerodyn@snu.ac.kr
³Department of Emergency Medicine Cheju National University Hospital, Korea.

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.

Key words: Radiology, Emergency Medicine, Internship and Residency, Diagnostic Variation, Magnetic Resonance Imaging Tomography, X-Ray, Computed