title: Overnight resident preliminary interpretations on CT examinations: should the process continue?
abstract: We report our experience with resident preliminary interpretations given at night on both abdominal and neurological CT scans to quantify the discrepancy rate when compared to the final report. An attempt was also made to document any adverse clinical outcomes as a result of the preliminary interpretation. From January 1, 2004 to December 31, 2004, adult CT examinations were prospectively interpreted by residents at night at a level I trauma center. Both the neurological and body CT scans were reviewed beginning at 7:00 a.m. the following morning by the respective subspecialty staff and discrepancies were noted. Adult CT examinations (6,858) were prospectively interpreted by residents: 5,206 cranial spinal CT examinations and 1,652 body CT examinations. Among the neurological studies, there were six cases identified as major discrepancies (0.1%) and 185 minor discrepancies (3.5%). Among the body CT cases, there were seven cases identified as major discrepancies (0.4%) and 23 cases of minor discrepancies (1.4%). There is a low discrepancy rate (0.2% major and 3.1% minor) in the preliminary resident interpretations from the final report. The process of overnight preliminary CT interpretations should continue as it is not substandard care.
authors.affiliation: Department of Radiology, University of Cincinnati, 234 Goodman Street ML 0761, Cincinnati, OH 45267, USA. williamstrub@hotmail.com
authors.forename: William M
authors.initials: WM
authors.lastname: Strub
authors.forename: Achala A
authors.initials: AA
authors.lastname: Vagal
authors.forename: Thomas
authors.initials: T
authors.lastname: Tomsick
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Moulton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000000981:diagnostic imaging; D002983:Clinical Competence; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000293:injuries; D005189:False Positive Reactions; D005260:Female; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging; D006066:Gonads / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D009485:Neuroradiography; D015588:Observer Variation; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D011860:Radiography, Abdominal; D012107:Research Design; D012421:Rupture / Q000000981:diagnostic imaging; D019112:Teleradiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D020246:Venous Thrombosis / Q000000981:diagnostic imaging