On-Call Radiology Resident Preliminary Report Major Discrepancies: A Meta-analysis

Throughout their training, radiology residents frequently perform independent overnight call, with attendings overreading reports the following morning. Call shifts are a fundamental part of radiology resident training, offering independence that can improve decision-making skills and professional confidence. However, because errors have the potential to affect patient care, analysis of clinically significant errors is critical. This meta-analysis was performed to organize existing data on on-call resident preliminary report discrepancy rates and to compare rates across modalities and resident years.

A PubMed search was performed in August 2024 using ("resident report discrepancy" OR ("resident" AND "error") OR "preliminary") AND "radiology" AND "call". Articles were included if they met the criteria, and relevant information was collected. Statistical analysis was performed.

The PubMed search resulted in 107 articles, of which 20 met inclusion criteria. These studies included 616,918 preliminary reports. Pooled preliminary report major discrepancy rate (%) by modality was 0.64 for radiographs, 0.38 for US, 1.35 for CT, and 1.86 for MRI and by resident year was 1.27 for R1s, 1.05 for R2s, 0.88 for R3s, and 0.67 for R4s. The highest discrepancy rate was seen for R1s reading MRI (8.70%). The majority of papers included describe residents taking independent call, with only three having fellow or attending supervised call part of the time.

Radiology residents are valuable members of the healthcare team and demonstrate high accuracy during independent call shifts. Fellow or attending real-time supervision can shorten the time to final report, and whether a hospital implements this should be decided by analyzing its individual system. This analysis is limited by variability in the classification of major discrepancies and inability to further classify data by body region scanned. In light of this, we encourage standardization in future reporting.