title: Cross-sectional examination interpretation discrepancies between on-call diagnostic radiology residents and subspecialty faculty radiologists: analysis by imaging modality and subspecialty.
abstract: OBJECTIVE
  The aim of this study was to identify the rate of discrepancies between radiology residents and faculty radiologists at an academic hospital and to determine the distribution across subspecialties and modalities, specifically CT, MR, and ultrasound.
  
  
  METHODS
  Consecutive CT, MR, and ultrasound preliminary interpretations rendered by on-call second-year through fourth-year radiology residents for 9 months on emergency department patients, inpatients, and urgent outpatients formed the study population. All preliminary interpretations were graded using a modified RADPEER(®) system (scores 0 and 1 = concordance; score 2 = minor, clinically insignificant discordance; scores 3 and 4 = clinically significant discordance) by the subspecialty faculty members who rendered the final interpretation.
  
  
  RESULTS
  There were 158 clinically significant discrepancies out of 21,482 preliminary interpretations, for a discrepancy rate of 0.7%. There was no statistically significant difference in rates across subspecialties or between adult and pediatric examinations (cardiothoracic, 1%; abdominal, 0.7%; neuroradiology, 0.6%; musculoskeletal, 0.7%; pediatrics, 0.8%). MR and CT interpretations had significantly higher rates than ultrasound (MR, 1.4%; CT, 0.9%; ultrasound, 0.2%; P < .001). Within neuroradiology, there was a significantly higher rate for MR than CT (1.5% vs 0.6%, P < .01), and within abdominal radiology, there was a significantly higher rate for CT than ultrasound (1.1% vs 0.2%, P < .01).
  
  
  CONCLUSIONS
  Discrepancy rates in this study were less than or comparable with those reported previously and within or lower than rates for practicing radiologists. Discrepancy rates varied among subspecialties and modalities, suggesting the use of a RADPEER system with attention to modality and subspecialty as a methodology for identifying areas for targeted resident education.
authors.affiliation: Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Ruma
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Klein
authors.forename: Suzanne
authors.initials: S
authors.lastname: Chong
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wesolowski
authors.forename: Ella A
authors.initials: EA
authors.lastname: Kazerooni
authors.forename: James H
authors.initials: JH
authors.lastname: Ellis
authors.forename: James D
authors.initials: JD
authors.lastname: Myles
mesh_terms: D003430:Cross-Sectional Studies; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D005180:Faculty, Medical / Q000706:statistics & numerical data*; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008824:Michigan; D015588:Observer Variation; D011871:Radiology / Q000706:statistics & numerical data*