Chest radiography: a tool for the audit of report quality

In a radiology department, clinical audit implies multiple readings of selected images to identify those findings that should be recognized and to document any departure from this standard for each radiologist. The authors developed an alternate approach for an audit on the basis of clinical outcomes collected in a medical computing facility. Techniques borrowed from information theory were used to measure the clinical information contributed by radiologists as they interpreted chest radiographs. The reported findings were evaluated in light of the discharge diagnosis. The scores generated quantified the information contributed to the final diagnosis by the radiologist's description. This audit approach was tested in a group of 100 chest radiographs. Significant differences were found in the mean scores for information contributed by five different readers. These differences were similar to differences demonstrated in audits by means of multiple readings of chest radiographs. These results support use of a form of audit that is substantially less expensive and time consuming than that typically used in radiology departments.