Majority of residents' after-hours CT report discrepancies not clinically significant
Residents interpreting exams after hours are more prone to making reporting mistakes. A new analysis examines how likely it is for these discrepancies to lead to changes in diagnosis and patient care.
Published in Emergency Radiology, the new data suggest that although report discrepancies between residents’ interpretations and patients’ final reports are common, they typically are not clinically significant. In fact, the rate of error detailed in this most recent paper was actually lower than what previous reports have indicated.
“Several prior international studies have examined radiology resident reporting discrepancy rates, with a range of 1%–10% quoted,” Seamus J O’Flaherty, with the department of radiology at Austin Health in Australia, and colleagues noted. “Limited data exists specifically for the after-hours setting, where residents are often staffed at training institutions and report most, or all, studies.”
For their work, the team evaluated 2,000 after-hours resident CT reports filed between April and July 2022. Residents’ preliminary reports were compared alongside the final ones submitted by attending physicians and categorized in 15 sub-categories; including those that were minor, major and clinically significant.
The team calculated an overall discrepancy rate of 44.3%. Of those, the majority (67.8%) were considered minor errors, while around 20% were catagorized as major. Encouragingly, less than 2.5% of the errors were clinically significant.
In terms of the specific type of discrepancy recorded, diagnostic misses were the most common, at 16.9%, followed by false positives, at 5.7%. Second year residents were more likely than third year residents to commit errors. What’s more, error rates were higher for cases reported in the evening compared to after-hours shifts, and weeknight shift discrepancies were more common than errors on weekends.
The group was encouraged by their findings that residents’ discrepancies are most often minor, suggesting that their staggered after-hours reporting model is effective at reducing errors.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.