Quality control in neuroradiology: discrepancies in image interpretation among academic neuroradiologists.
Prior studies have found a 3%-6% clinically significant error rate in radiology practice. We set out to assess discrepancy rates between subspecialty-trained university-based neuroradiologists. Over 17 months, university neuroradiologists randomly reviewed 1000 studies and reports of previously read examinations of patients in whom follow-up studies were read. The discrepancies between the original and "second opinion" reports were scored according to a 5-point scale: 1, no change; 2, clinically insignificant detection discrepancy; 3, clinically insignificant interpretation discrepancy; 4, clinically significant detection discrepancy; and 5, clinically significant interpretation discrepancy. Of the 1000 studies, 876 (87.6%) showed agreements with the original report. The neuroradiology division had a 2.0% (20/1000; 95% CI, 1.1%-2.9%) rate of clinically significant discrepancies involving 8 CTs and 12 MR images. Discrepancies were classified as vascular (n = 7), neoplastic (n = 9), congenital (n = 2), and artifacts (n = 2). Individual neuroradiologist's scores ranged from 0% to 7.7% ± 2.3% (n = 18). Both CT and MR imaging studies had a discrepancy rate of 2.0%. Our quality assessment study could serve as initial data before intervention as part of a PQI project.
Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
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D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008396:Maryland; D009485:Neuroradiography / Q000592:standards* / Q000706:statistics & numerical data*; D015588:Observer Variation; D010820:Physicians / Q000706:statistics & numerical data*; D011361:Professional Competence / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*