Radiographic Reread Protocols to Identify Clinically Relevant Errors in Initial Trauma Evaluations.

Area of Science:

• Radiology
• Trauma Care
• Diagnostic Accuracy

Background:

• Diagnostic radiology interpretive errors in trauma patients can lead to missed diagnoses.
• A level II trauma center implemented a 24-hour reread protocol for highest trauma activation level (Code T) patients.

Purpose of the Study:

• To determine the efficacy of a reread protocol in identifying missed diagnoses in Code T patients.
• To hypothesize that a few, but clinically relevant errors, would be identified upon reread.

Main Methods:

• Reviewed all radiographic study findings (initial read and reread) for Code T admissions from July 2015 to May 2016.
• Categorized findings into: agreement, minor non-clinically relevant error, clinically relevant error, or trauma surgeon notified.

Main Results:

• 3 (0.40%) minor clinically relevant errors and 11 (1.46%) non-clinically relevant errors were identified among 752 studies.
• Clinically relevant errors included fractures of the mandible, temporal bone, and ribs.
• 98.1% of interpretations agreed with the original read.

Conclusions:

• Clinically relevant errors were discovered through the reread protocol, though they were minimal.
• None of the identified clinically significant errors affected patient outcomes.
• Reread protocol implementation should be based on institution-specific practices.