Improving performance by multiple interpretations of chest radiographs: effectiveness and cost.
The accuracy and cost of four methods of duplicate reading were evaluated. Eight radiologists interpreted 100 random chest radiographs. Using a third independent interpretation to resolve disagreements between pairs of readers ("Pseudoarbitration") was the most effective method overall, reducing errors 37%, increasing correct interpretations 18%, and adding 19% to the cost of an error-free interpretation. Resolving disagreements in facor of positive diagnoses was the best method for reducing omissions, but it almost doubled false-positive diagnoses. The choice between single and multiple interpretations must be evaluated in each clinical setting and should consider expected improvements in accuracy, implications for patient care, and additional costs.
D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003951:Diagnostic Errors; D006801:Humans; D007600:Judgment; D008722:Methods; D008962:Models, Theoretical; D013902:Radiography, Thoracic / Q000191:economics / Q000592:standards; D011871:Radiology