Related Experiment Videos
Radiographs in the office: is a second reading always needed?
Paul D Smith1, Jonathan Temte, John W Beasley
1Department of Family Medicine, University of Wisconsin Medical School, Madison, 53715-1896, USA. psmith@fammed.wisc.edu
The Journal of the American Board of Family Practice
|July 10, 2004
Summary
Primary care clinicians can accurately identify when a radiologist
Area of Science:
- Radiology
- Primary Care Medicine
- Medical Decision Making
Background:
- Assessing the impact of differing outpatient radiograph readings on patient care.
- Investigating cases where primary care clinicians might not seek a radiologist's second opinion.
Purpose of the Study:
- To determine the frequency, nature, and significance of patient care changes due to discrepancies in radiograph interpretations.
- To evaluate the ability of primary care clinicians to predict when a radiologist's second reading will not lead to substantial care modifications.
Main Methods:
- Collected 1393 pairs of radiographic readings from 9 primary care practices over 4 months.
- Analyzed 553 cases where clinicians hypothetically would not request a radiologist's consultation.
- Reviewed patient charts to identify changes in clinical care resulting from radiologists' second readings.
Main Results:
- Radiologists' second readings led to changes in care in 14% of discordant cases (2.5% of all reviewed cases).
- Identified 38 documented or presumed changes in care.
- Found zero instances of substantial changes in care based on the radiologist's second reading.
Conclusions:
- Primary care clinicians possess the capability to identify radiographs unlikely to necessitate a radiologist's second reading for substantial care adjustments.
- This suggests efficient resource allocation and avoidance of unnecessary consultations.