title: The clinical impact of subspecialized radiologist reinterpretation of abdominal imaging studies, with analysis of the types and relative frequency of interpretation discrepancies.
abstract: OBJECTIVE
  The primary objective of this study was to determine the clinical impact and value of abdominal imaging reinterpretations by subspecialized abdominal imagers.
  
  
  METHODS
  Secondary interpretations for computed tomography (CT), magnetic resonance (MR), and ultrasound (US) abdominal studies performed outside our institution over a 7-month period were retrospectively compared to the primary (outside) interpretation, with interpretive differences recorded. Clinical notes, pathology and subsequent imaging determined ground truth diagnosis and the clinical impact of any interpretive discrepancies were graded as having high, medium, or little/no clinical impact. Interpretive comparisons were scored into categories: (1) no difference; (2) incidental findings of no clinical impact; (3) finding not reported; (4) significance of finding undercalled; (5) significance of finding overcalled; (6) finding misinterpreted; and (7) multiple discrepancy types in one report.
  
  
  RESULTS
  398 report comparisons were reviewed on 380 patients. There were 300 CT, 60 MR, and 38 US examinations. The primary report had 5.0% (20/398) high clinical impact interpretive discrepancies and 7.5% (30/398) medium clinical impact discrepancies. The subspecialized secondary report had no high clinical impact discrepancies and 8/398 (2.0%) medium clinical impact discrepancies. In order of frequency, high and medium impact discrepancies in the primary report consisted of 50% overcalls, 26% unreported findings, 18% undercalls, 4% misinterpretations, and 2% multiple discrepancies.
  
  
  CONCLUSIONS
  Subspecialty review of abdominal imaging exams can provide clinical benefit. Half of the discrepancies in this series of abdominal reinterpretations were due to overcalls.
authors.affiliation: Mayo Clinic Rochester, 200 First Street SW, Rochester, MN, 55905, USA, Lindgren.elizabeth@mayo.edu.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Lindgren
authors.forename: Maitray D
authors.initials: MD
authors.lastname: Patel
authors.forename: Qing
authors.initials: Q
authors.lastname: Wu
authors.forename: Jeff
authors.initials: J
authors.lastname: Melikian
authors.forename: Amy K
authors.initials: AK
authors.lastname: Hara
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging* / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods* / Q000592:standards*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011860:Radiography, Abdominal / Q000379:methods*; D011871:Radiology / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013038:Specialization; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography / Q000379:methods; D055815:Young Adult