title: Radiology resident interpretations of on-call imaging studies: the incidence of major discrepancies.
abstract: OBJECTIVE
  To determine the incidence of radiology resident preliminary interpretation errors for plain film, body computed tomography, and neuroradiology (neuro)computed tomographic examinations read on call.
  
  
  METHODS
  We retrospectively reviewed the data in a prospectively acquired resident quality assurance (QA) database dating between January 2000 and March 2007. The database comprises all imaging studies initially interpreted by an on-call resident and later reviewed by a board-certified attending radiologist who determined the level of discrepancy between the two interpretations according to a graded scale from 0 (no discrepancy) to 3 (major discrepancy). We reviewed the data with respect to resident training level, imaging modality, and variance level. Statistical analysis was performed with chi2 test, alpha=0.05. We compared our results with other published series studying resident and attending accuracy.
  
  
  RESULTS
  A total of 141,381 cases were entered into the database during the review period. Of all examinations, 95.7% had zero variance, 3.3% minor variance, and 1.0% major variance. There was a slight, statistically significant increase in overall accuracy with increased resident year from 95.4% of examinations read by first-year residents (R1s) to 96.1% by fourth-year resident (R4s) (P<.0001). Overall percentages of exams with major discrepancies were 1.0% for R1s, 1.1% for second-year residents, 1.0% for third-year residents, and 0.98% for R4s.
  
  
  CONCLUSIONS
  The majority of preliminary resident interpretations are highly accurate. The incidence of major discrepancies is extremely low and similar, even with R1s, to that of attending radiologists published in other studies. A slight, statistically significant decrease in the error rate is detectable as residents gain experience throughout the 4 years of residency.
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 800, Chicago, IL 60611, USA.
authors.forename: Victoria F
authors.initials: VF
authors.lastname: Cooper
authors.forename: Lori A
authors.initials: LA
authors.lastname: Goodhartz
authors.forename: Albert A
authors.initials: AA
authors.lastname: Nemcek
authors.forename: Robert K
authors.initials: RK
authors.lastname: Ryu
mesh_terms: D003951:Diagnostic Errors; D007396:Internship and Residency; D015588:Observer Variation; D011785:Quality Assurance, Health Care; D011871:Radiology / Q000193:education* / Q000592:standards*; D012189:Retrospective Studies; D014481:United States