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Application of the RADPEER™ scoring language to interpretation discrepancies between diagnostic radiology residents
Ezekiel Maloney1, Laurie M Lomasney, Linda Schomer
1Department of Radiology, Loyola University Medical Center, Maywood, Illinois 60153, USA. ezmaloney@lumc.edu
Purpose:
The objectives of this study were to assess the rate of discrepancies between radiology residents and faculty radiologists at an academic hospital using the RADPEER(™) scoring language and to determine if a correlation existed between assigned RADPEER score (2, 3, or 4) and the clinical significance of the error.
Methods:
Over 19 months, preliminary resident interpretations were graded using the RADPEER scoring system. A retrospective review of discrepant cases was performed to assess the percentage of discrepancy, change in clinical management, and identification of error patterns.
Results:
Of 2,255 preliminary interpretations, 29 discrepancies (1.29%) were judged to be potentially clinically significant. Of these, 14 (0.62%) resulted in immediate changes in clinical management. Discrepancies assigned RADPEER scores of 3 or 4 were significantly more likely to be judged clinically significant than those assigned scores of 2 (54.5% of 33 studies graded 3 or 4 and 7.7% of 142 studies graded 2, P < .0001). CT imaging generated a higher percentage of discrepancies that were predicted to be clinically significant than plain-film radiography, as well as a higher percentage of discrepancies that resulted in immediate changes in management, but the incidence of each remained low overall (≤2.1%).
Conclusions:
Discrepancy rates in this study are comparable with previously reported data for discrepancies between attending radiologists and those between attending radiologists and residents data. A significant correlation was observed between increasing RADPEER scores and the clinical significance of discrepancies. This study supports the use of the RADPEER scoring language as both a resident quality assurance measure and an educational tool for quality improvement.
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