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Frequency and Clinical Utility of Alerts for Intra-Institutional Radiologist Discrepant Opinions
Pamela J DiPiro1, Andro Licaros2, Anna H Zhao3
1Radiology Quality and Safety Officer, Department of Radiology, Center for Evidence-Based Imaging, Brigham and Women's Hospital, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Intra-institutional discrepant radiologist opinions are rare but often change clinical management. Documenting these discrepancies through alerts can improve patient care and communication among care teams.
Area of Science:
- Radiology
- Medical Informatics
- Patient Safety
Background:
- Discrepancies in radiologist interpretations within an institution can impact patient care.
- A policy was implemented requiring closed-loop notification for discrepant opinions.
Purpose of the Study:
- To determine the rate of documented notification for intra-institutional discrepant radiologist opinions.
- To assess the impact of these discrepancies on clinical management and report addenda.
Main Methods:
- Retrospective study at a large academic medical center.
- Analyzed discrepant opinion alerts from December 2019 to December 2021.
- Assessed discrepancy severity, clinical management changes, and report addendum rates.
Main Results:
- 0.006% of reports (114/1,888,147) had discrepant opinions.
- Major discrepancies occurred in 50.9% of cases.
- Clinical management changed in 56.1% of cases with discrepancies.
- Report addendum rate for discrepancies was 21%, four times higher than peer learning alerts.
Conclusions:
- Discrepant radiologist opinions, though infrequent, significantly influence clinical management.
- Encouraging alert use for discrepancies can optimize patient care and communication.
- This process aids in documenting communications between consulting radiologists and care teams.
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