Body MRI Subspecialty Reinterpretations at a Tertiary Care Center: Discrepancy Rates and Error Types.

Area of Science:

• Radiology
• Medical Imaging
• Diagnostic Accuracy

Background:

• Tertiary care centers often perform secondary interpretations of imaging studies for transferred patients.
• Discrepancy rates in radiology vary, with higher rates observed in secondary interpretations compared to preliminary resident overreads.
• Abdominal, pelvic, and cross-sectional imaging exhibit the highest discrepancy rates.

Purpose of the Study:

• To determine the discrepancy rate between outside abdominal and pelvic MRI reports and secondary interpretations at a tertiary care center.
• To identify the most common reasons for discrepancies in these secondary interpretations.
• To categorize discrepancies into perceptive and cognitive errors.

Main Methods:

• Retrospective review of 395 secondary body MRI reports from January 2015 to December 2018.
• Exclusion of 38 cases due to categorization issues or missing outside reports.
• Comparison of outside MRI reports with secondary interpretations, categorizing discrepancies and their causes (perceptive vs. cognitive errors).

Main Results:

• A high discrepancy rate of 68.9% (246 out of 357 cases) was found in secondary MRI interpretations.
• Faulty reasoning, a cognitive error involving misidentification of abnormalities, was the primary reason for discrepancies (34.3%).
• Satisfaction of search, a perceptive error, was the most common cause for secondary discrepancies (15.0%).

Conclusions:

• Secondary interpretations of body MRI examinations at tertiary care centers yield a significant rate of discrepancies.
• Cognitive errors, particularly faulty reasoning, are the predominant type of error in these secondary interpretations.
• The findings highlight the importance of careful review and potential for error in secondary radiology interpretations.