Correlation of emergency department radiographs: results of a quality assurance review in an urban community hospital setting.
BACKGROUND
The study objective was to compare the accuracy of radiograph interpretation by emergency and family physicians with radiologists' overreadings.


METHODS
We undertook a historical chart review of patients seen consecutively during a 1-year period at an inner-city emergency department of a medium-volume community hospital. The participants were a racially mixed group of 22,141 patients for whom 12,083 radiographs had been ordered. We compared interpretations by emergency and family physicians with those of radiologists who performed overreadings within 24 hours. This intervention was performed retrospectively. Measurements consisted of descriptive statistics, such as percentages and chi-square analysis.


RESULTS
The main result was an overall discrepancy rate (ODR) of 1.1 percent. This figure is significantly different (P < 0.0001) from the lowest reported overall discrepancy rate to date (2.8 percent).


CONCLUSIONS
Consistently low overall discrepancy rates have specific implications for the medical practice and reimbursement of primary care physicians for radiograph interpretation.
Warren
J S
JS
Department of Family Medicine, University of Tennessee, Memphis 38104.
Lara
K
K
Connor
P D
PD
Cantrell
J
J
Hahn
R G
RG
D002983:Clinical Competence; D003951:Diagnostic Errors; D004635:Emergency Medicine / Q000592:standards*; D004636:Emergency Service, Hospital; D005194:Family Practice / Q000592:standards*; D006764:Hospitals, Community; D006786:Hospitals, Urban; D006801:Humans; D008485:Medical Audit; D011859:Radiography / Q000592:standards*; D012189:Retrospective Studies