Radiologists Make More Errors Interpreting Off-Hours Body CT Studies during Overnight Assignments as Compared with...

Area of Science:

• Radiology
• Medical Imaging
• Clinical Performance

Background:

• Growing research interest in overnight work's effect on radiologist performance.
• Previous studies focused on resident errors, not board-eligible/certified radiologists' night vs. day performance.
• Need to assess interpretation errors in academic radiology fellows during off-hours.

Purpose of the Study:

• To analyze the rate of clinically important interpretation errors on body CT studies.
• To compare error rates between daytime and nighttime assignments for radiology fellows.
• To evaluate if error rates differ in the first versus latter halves of off-hour assignments.

Main Methods:

• Retrospective review of 10,090 body CT studies interpreted by 32 fellows (July 2014-June 2018).
• Attending physicians reviewed studies interpreted off-hours within 10 hours of initial interpretation.
• Errors classified as discrepancies affecting acute or follow-up clinical care; statistical analysis using chi-squared tests and general estimating equations.

Main Results:

• Higher error rate for nighttime studies (3.0%) compared to daytime studies (2.0%; P = .02).
• 69% of radiologists had higher error rates during night assignments (P = .03).
• Error rates were higher in the latter half of night assignments (3.7%) versus the first half (2.5%; P = .002).

Conclusions:

• Clinically important off-hours body CT interpretation errors are more frequent overnight.
• Error rates increase in the latter part of night assignments, suggesting fatigue impact.
• A majority of radiologists demonstrated worse performance at night compared to day.