Bias in Neuroradiology Peer Review: Impact of a "Ding" on "Dinging" Others

The validity of radiology peer review requires an unbiased assessment of studies in an environment that values the process. We assessed radiologists' behavior reviewing colleagues' reports. We hypothesized that when a radiologist receives a discrepant peer review, he is more likely to submit a discrepant review about another radiologist.

We analyzed the anonymous peer review submissions of 13 neuroradiologists in semimonthly blocks of time from 2016 to 2018. We defined a discrepant review as any one of the following: 1) detection miss, clinically significant; 2) detection miss, clinically not significant; 3) interpretation miss, clinically significant; or 4) interpretation miss, clinically not significant. We used random-effects Poisson regression analysis to determine whether a neuroradiologist was more likely to submit a discrepant report during the semimonthly block in which he or she received one versus the semimonthly block thereafter.

Four hundred sixty-eight discrepant peer review reports were submitted; 161 were submitted in the same semimonthly block of receipt of a discrepant report and 325 were not. Receiving a discrepant report had a positive effect on submitting discrepant reports: an expected relative increase of 14% (95% CI, 8%-21%). Notably, receiving a clinically not significant discrepant report (coefficient = 0.13; 95% CI, 0.05-0.22) significantly and positively correlated with submitting a discrepant report within the same time block, but this was not true of clinically significant reports.

The receipt of a clinically not significant discrepant report leads to a greater likelihood of submitting a discrepant report. The motivation for such an increase should be explored for potential bias.