Academic radiology and the emergency department: does it need changing?

Area of Science:

• Radiology
• Medical Imaging
• Emergency Medicine

Background:

• Increasing demand for 24/7 radiology services, particularly in emergency departments (EDs).
• Need for efficient and accurate preliminary radiology interpretations for patient care.

Purpose of the Study:

• To compare the accuracy of resident preliminary radiology reports with generalist and subspecialist interpretations.
• To evaluate the error rates in radiology reporting within an academic trauma ED.

Main Methods:

• Analysis of radiology information system data for ED imaging volume.
• Literature review of error and discordant rates in radiology interpretations.
• Prospective collection and comparison of resident preliminary reports with final subspecialty interpretations over a 2-week period.

Main Results:

• The ED accounted for 16% of total radiology volume.
• Resident preliminary reports showed a 0.6% discordance rate with final subspecialty reports.
• Published error rates between certified radiologists exceed those between residents and subspecialists.

Conclusions:

• Resident preliminary reports in the ED demonstrate a low error rate.
• The perceived error rate by clinicians is higher than the actual detected error rate.
• Academic radiology departments need to optimize their approach to handling ED cases.