title: Application of the RADPEER™ scoring language to interpretation discrepancies between diagnostic radiology residents and faculty radiologists.
abstract: OBJECTIVE
  The objectives of this study were to assess the rate of discrepancies between radiology residents and faculty radiologists at an academic hospital using the RADPEER(™) scoring language and to determine if a correlation existed between assigned RADPEER score (2, 3, or 4) and the clinical significance of the error.
  
  
  METHODS
  Over 19 months, preliminary resident interpretations were graded using the RADPEER scoring system. A retrospective review of discrepant cases was performed to assess the percentage of discrepancy, change in clinical management, and identification of error patterns.
  
  
  RESULTS
  Of 2,255 preliminary interpretations, 29 discrepancies (1.29%) were judged to be potentially clinically significant. Of these, 14 (0.62%) resulted in immediate changes in clinical management. Discrepancies assigned RADPEER scores of 3 or 4 were significantly more likely to be judged clinically significant than those assigned scores of 2 (54.5% of 33 studies graded 3 or 4 and 7.7% of 142 studies graded 2, P < .0001). CT imaging generated a higher percentage of discrepancies that were predicted to be clinically significant than plain-film radiography, as well as a higher percentage of discrepancies that resulted in immediate changes in management, but the incidence of each remained low overall (≤2.1%).
  
  
  CONCLUSIONS
  Discrepancy rates in this study are comparable with previously reported data for discrepancies between attending radiologists and those between attending radiologists and residents data. A significant correlation was observed between increasing RADPEER scores and the clinical significance of discrepancies. This study supports the use of the RADPEER scoring language as both a resident quality assurance measure and an educational tool for quality improvement.
authors.affiliation: Department of Radiology, Loyola University Medical Center, Maywood, Illinois 60153, USA. ezmaloney@lumc.edu
authors.forename: Ezekiel
authors.initials: E
authors.lastname: Maloney
authors.forename: Laurie M
authors.initials: LM
authors.lastname: Lomasney
authors.forename: Linda
authors.initials: L
authors.lastname: Schomer
mesh_terms: D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005180:Faculty, Medical / Q000706:statistics & numerical data*; D007087:Illinois; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D015588:Observer Variation; D011785:Quality Assurance, Health Care / Q000379:methods*; D011871:Radiology / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity