title: Radiology resident interpretation of on-call CT pulmonary angiograms.
abstract: OBJECTIVE
  To evaluate the interpretation of computed tomographic pulmonary angiograms performed outside of regular reporting hours, comparing the initial interpretation by the radiology resident to the attending radiologist.
  
  
  METHODS
  Records for 840 consecutive computed tomographic pulmonary angiograms (CTPA) performed outside of regular reporting hours at two tertiary referral centers from January 1, 2004-December 31, 2005 were reviewed. The preliminary interpretation by the on-call radiology resident was compared to the subsequent final report issued by a subspecialty trained chest radiologist. Studies were stratified as positive, negative, or equivocal for pulmonary embolus. Cases with discordant interpretations or negative CTPA were reviewed to determine impact on clinical outcome. Patients were followed up to 12 months after CTPA to document any subsequent thromboembolic event.
  
  
  RESULTS
  Sixteen percent (131/840) of CTPAs were reported positive by the staff radiologist. There was agreement in 90% (752/840) of studies (P = .76, 95% confidence interval, 0.71-0.81) with 86% (114/133) agreement for studies interpreted as positive by residents, 95% (582/612) for studies interpreted as negative by residents, and 63% (60/95) for studies interpreted as equivocal by residents. Studies of optimal quality had higher interobserver agreement than studies of suboptimal quality (P < .0001). In-patient studies were more likely to be positive than emergency room patients (20% vs. 13%) (P = .004). No adverse clinical outcomes were attributed to discordant interpretations.
  
  
  CONCLUSIONS
  Radiology residents provide a high level interpretation of on-call CTPA studies, achieving good concordance with the attending radiologists' assessment.
authors.affiliation: Department of Diagnostic Imaging, Mount Sinai Hospital, Toronto, Ontario, Canada M5G 2N2.
authors.forename: Patrick
authors.initials: P
authors.lastname: Cervini
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Roberts
authors.forename: Yves L
authors.initials: YL
authors.lastname: Provost
authors.forename: Tae-Bong
authors.initials: TB
authors.lastname: Chung
authors.forename: Narinder S
authors.initials: NS
authors.lastname: Paul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D016009:Chi-Square Distribution; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011871:Radiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D000078329:Workforce