Accuracy of Provisional Reports by Radiology Residents on Call

Background Out-of-hours (OOH) CT and MRI examinations at our institution are provisionally reported by on-call radiology residents and used to guide overnight patient management. We aimed to quantify the overnight discrepancy rate between provisional resident reports and subsequent consultant reports, and explore associations between discrepancies and resident grade, study type, and reporting time. Methods This registered service evaluation retrospectively reviewed all consecutive CT and MRI examinations provisionally reported overnight by radiology residents between 13 June 2022 and 3 July 2022. Provisional reports were compared with the final consultant reports. Discrepancies were categorised as minor, significant, or major using predefined criteria by an ST4 radiology resident. Results In total, 993 imaging examinations were included. The overall discrepancy rate was 144 (14.5%). Major and significant discrepancies comprised 56 of 993 (5.6%) examinations and were considered potentially management-altering. Discrepancy rates varied significantly by imaging speciality (chi-square (χ²) test, p < 0.001): body imaging (21.6%), musculoskeletal (MSK) imaging (17.2%), neuro-radiological imaging (11.7%), and vascular imaging (5.4%). No statistically significant association was identified between discrepancy rates and resident training grade (χ² test, p = 0.48) or one-hour reporting time block (χ² test, p = 0.37). Conclusion This service evaluation showed that provisional radiology reporting is associated with a meaningful discrepancy burden, paying careful attention to variation across imaging specialities. Notably, no statistically significant association was identified between discrepancy rates and resident seniority or time of reporting. Timely consultant review, structured feedback and targeted quality improvement with re-audit will support safe and accurate OOH reporting.