title: Peer review comments augment diagnostic error characterization and departmental quality assurance: 1-year experience from a children's hospital.
abstract: OBJECTIVE
  The objective of our study was to categorize radiologist peer review comments and evaluate their functions within the context of a comprehensive quality assurance (QA) program.
  
  
  METHODS
  All randomly entered radiology peer review comments at our institution were compiled over a 1-year period (January 1, 2011, through December 31, 2011). A Web-based commercially available software package was used to query the comments, which were then exported into a spreadsheet. Each comment was then placed into a single most appropriate category based on consensus decision of two board-certified pediatric radiologists. QA scores associated with each comment were recorded.
  
  
  RESULTS
  A total of 427 peer review comments were evaluated. The majority of comments (85.9%) were entered voluntarily with QA scores of 1. A classification system was devised that augments traditional error classification. Seven broad comment categories were identified: errors of observation (25.5%), errors of interpretation (5.6%), inadequate patient data gathering (3.7%), errors of communication (9.6%), interobserver variability (21.3%), informational and educational feedback (23.0%), and complimentary (11.2%).
  
  
  CONCLUSIONS
  Comment-enhanced peer review expands traditional diagnostic error classification, may identify errors that were underscored, provides continuous educational feedback for participants, and promotes a collegial environment.
authors.affiliation: Department of Radiology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA. riyer@uw.edu
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Iyer
authors.forename: Jonathan O
authors.initials: JO
authors.lastname: Swanson
authors.forename: Randolph K
authors.initials: RK
authors.lastname: Otto
authors.forename: Edward
authors.initials: E
authors.lastname: Weinberger
mesh_terms: D003951:Diagnostic Errors; D006776:Hospitals, Pediatric; D006801:Humans; D018024:Peer Review, Health Care; D011785:Quality Assurance, Health Care; D011872:Radiology Department, Hospital / Q000592:standards*