title: False-positive preliminary radiograph interpretations in a pediatric emergency department: clinical and economic impact.
abstract: A prospective, case control study at a university-affiliated, academic pediatric emergency department was undertaken to determine the clinical impact and cost of false-positive preliminary radiograph interpretations and to compare the cost of false-positive interpretations with the estimated cost of a 24-hour on-site pediatric radiologist. Data were collected on all patients undergoing radiography of the chest, abdomen, lateral (soft tissue) neck, cervical spine, or extremities during a 5-month period. A total of 1,471 radiograph examinations was performed, and 200 (14%) misinterpretations (false-positive and false-negative) by the pediatric emergency medicine physicians were identified. As reported previously, 20 (10%) of the false-negative interpretations were noted to be clinically significant, in the current analysis, 103 (7%) false-positive radiograph interpretations were identified. False-positive interpretations were noted more frequently (14%) for soft tissue lateral neck radiographs than for any other radiograph type. Of the 103 total false-positive radiographs, nine (0.6%) resulted in an increased patient cost totaling $764.75. These data show that false-positive radiograph interpretations have limited economic and clinical impact.
authors.affiliation: Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee 53226, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Walsh-Kelly
authors.forename: H M
authors.initials: HM
authors.lastname: Hennes
authors.forename: M D
authors.initials: MD
authors.lastname: Melzer-Lange
mesh_terms: D016022:Case-Control Studies; D002648:Child; D003951:Diagnostic Errors; D004636:Emergency Service, Hospital; D005188:False Negative Reactions; D005189:False Positive Reactions; D017721:Hospital Costs; D006776:Hospitals, Pediatric; D006801:Humans; D011446:Prospective Studies; D011859:Radiography / Q000191:economics / Q000592:standards*; D014922:Wisconsin