The Misinterpretation Rates of Radiology Residents on Emergent Neuroradiology Magnetic Resonance (MR) Angiogram Studies: Correlation with Level of Residency Training

Overview

Journal Emerg Radiol

Specialties Emergency Medicine
Radiology

Date 2009 Jun 6

PMID 19499257

Citations 5

Authors

Christopher G Filippi

Russell E Meyer

Keith Cauley

Joshua P Nickerson

Heather N Burbank

Jason M Johnson

Grant J Linnell

Gray F Alsofrom

Affiliations

Soon will be listed here.

Abstract

The purpose of this study was to determine the discrepancy rates of radiology residents interpreting emergent neck and Circle of Willis magnetic resonance angiography (MRA) studies and to detect any adverse clinical outcomes. Three hundred seventeen MRA studies given preliminary reading by radiology residents were retrospectively reviewed over a 2-year period. Discrepancies were classified as either false negatives (failure to diagnose abnormalities) or false positives (misinterpreting normal scans as abnormal). The overall discrepancy rate was 12.1% for Circle of Willis MRA and 7.9% for neck MRA. Fourth-year residents had the lowest discrepancy rates (7.7%), but this was not statistically significant. The most common misses were stenosis greater than 70% (n = 9) and aneurysm (n = 12). No adverse clinical outcome was detected mainly due to rapid turnaround time for final reporting.

Citing Articles

Discrepancy rate and clinical impact of preliminary reports from radiology residents.

Orejuela-Zapata J, Mejia-Quinones V, Granados-Sanchez A Heliyon. 2023; 9(8):e18714.

PMID: 37576198 PMC: 10415655. DOI: 10.1016/j.heliyon.2023.e18714.

Multidimensional Deep Learning Reduces False-Positives in the Automated Detection of Cerebral Aneurysms on Time-Of-Flight Magnetic Resonance Angiography: A Multi-Center Study.

Terasaki Y, Yokota H, Tashiro K, Maejima T, Takeuchi T, Kurosawa R Front Neurol. 2022; 12:742126.

PMID: 35115991 PMC: 8805516. DOI: 10.3389/fneur.2021.742126.

Factors affecting incorrect interpretation of abdominal computed tomography in non-traumatic patients by novice emergency physicians.

Lee S, Cho H, Kim J, Song J, Park J Clin Exp Emerg Med. 2021; 8(3):207-215.

PMID: 34649409 PMC: 8517467. DOI: 10.15441/ceem.20.118.

Does level of training influence the ability to detect hepatosplenomegaly in children with leukemia?.

Johnston D, Cyr J Can Med Educ J. 2015; 3(2):e146-50.

PMID: 26451185 PMC: 4563634.

A systematic review of the effects of residency training on patient outcomes.

van der Leeuw R, Lombarts K, Arah O, Heineman M BMC Med. 2012; 10:65.

PMID: 22742521 PMC: 3391170. DOI: 10.1186/1741-7015-10-65.

References

Ruchman R, Jaeger J, Wiggins 3rd E, Seinfeld S, Thakral V, Bolla S . 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. DOI: 10.2214/AJR.07.2307. View

Roszler M, McCarroll K, Rashid T, Donovan K, KLING G . Resident interpretation of emergency computed tomographic scans. Invest Radiol. 1991; 26(4):374-6. DOI: 10.1097/00004424-199104000-00016. View

Erly W, Ashdown B, Lucio 2nd R, Carmody R, Seeger J, Alcala J . Evaluation of emergency CT scans of the head: is there a community standard?. AJR Am J Roentgenol. 2003; 180(6):1727-30. DOI: 10.2214/ajr.180.6.1801727. View

Strub W, Vagal A, Tomsick T, Moulton J . Overnight resident preliminary interpretations on CT examinations: should the process continue?. Emerg Radiol. 2006; 13(1):19-23. DOI: 10.1007/s10140-006-0498-4. View

HERMAN P, Hessel S . Accuracy and its relationship to experience in the interpretation of chest radiographs. Invest Radiol. 1975; 10(1):62-7. DOI: 10.1097/00004424-197501000-00008. View

Seltzer S, Hessel S, HERMAN P, Swensson R, Sheriff C . Resident film interpretations and staff review. AJR Am J Roentgenol. 1981; 137(1):129-33. DOI: 10.2214/ajr.137.1.129. View

Velmahos G, Fili C, Vassiliu P, Nicolaou N, Radin R, Wilcox A . Around-the-clock attending radiology coverage is essential to avoid mistakes in the care of trauma patients. Am Surg. 2002; 67(12):1175-7. View

Le A, Licurse A, Catanzano T . Interpretation of head CT scans in the emergency department by fellows versus general staff non-neuroradiologists: a closer look at the effectiveness of a quality control program. Emerg Radiol. 2007; 14(5):311-6. DOI: 10.1007/s10140-007-0645-6. View

Wysoki M, Nassar C, Koenigsberg R, Novelline R, Faro S, Faerber E . Head trauma: CT scan interpretation by radiology residents versus staff radiologists. Radiology. 1998; 208(1):125-8. DOI: 10.1148/radiology.208.1.9646802. View

10.

Filippi C, Schneider B, Burbank H, Alsofrom G, Linnell G, Ratkovits B . Discrepancy rates of radiology resident interpretations of on-call neuroradiology MR imaging studies. Radiology. 2008; 249(3):972-9. DOI: 10.1148/radiol.2493071543. View

11.

Erly W, Berger W, Krupinski E, Seeger J, Guisto J . Radiology resident evaluation of head CT scan orders in the emergency department. AJNR Am J Neuroradiol. 2002; 23(1):103-7. PMC: 7975501. View

12.

Branstetter 4th B, Morgan M, Nesbit C, Phillips J, Lionetti D, Chang P . Preliminary reports in the emergency department: is a subspecialist radiologist more accurate than a radiology resident?. Acad Radiol. 2007; 14(2):201-6. DOI: 10.1016/j.acra.2006.11.001. View

13.

Lal N, Murray U, Eldevik O, Desmond J . Clinical consequences of misinterpretations of neuroradiologic CT scans by on-call radiology residents. AJNR Am J Neuroradiol. 2000; 21(1):124-9. PMC: 7976358. View

14.

Yoon L, Haims A, Brink J, Rabinovici R, Forman H . Evaluation of an emergency radiology quality assurance program at a level I trauma center: abdominal and pelvic CT studies. Radiology. 2002; 224(1):42-6. DOI: 10.1148/radiol.2241011470. View

15.

Wechsler R, Spettell C, Kurtz A, Halpern E, Nazarian L, Feld R . Effects of training and experience in interpretation of emergency body CT scans. Radiology. 1996; 199(3):717-20. DOI: 10.1148/radiology.199.3.8637994. View

16.

Strub W, Leach J, Ying J, Vagal A . First year radiology residents not taking call: will there be a difference?. Emerg Radiol. 2007; 13(5):231-5. DOI: 10.1007/s10140-007-0571-7. View