title: Performance results for a workstation-integrated radiology peer review quality assurance program.
abstract: OBJECTIVE
  To assess review completion rates, RADPEER score distribution, and sources of disagreement when using a workstation-integrated radiology peer review program, and to evaluate radiologist perceptions of the program.
  
  
  METHODS
  Retrospective review of prospectively collected data.
  
  
  METHODS
  Large private outpatient radiology practice.
  
  
  METHODS
  Radiologists (n = 66) with a mean of 16.0 (standard deviation, 9.2) years of experience.
  
  
  METHODS
  Prior studies and reports of cases being actively reported were randomly selected for peer review using the RADPEER scoring system (a 4-point scale, with a score of 1 indicating agreement and scores of 2-4 indicating increasing levels of disagreement).
  
  
  METHODS
  Assigned peer review completion rates, review scores, sources of disagreement and radiologist survey responses.
  
  
  RESULTS
  Of 31 293 assigned cases, 29 044 (92.8%; 95% CI 92.5-93.1%) were reviewed. Discrepant scores (score = 2, 3 or 4) were given in 0.69% (95% CI 0.60-0.79%) of cases and clinically significant discrepancy (score = 3 or 4) was assigned in 0.42% (95% CI 0.35-0.50%). The most common cause of disagreement was missed diagnosis (75.2%; 95% CI 66.8-82.1%). By anonymous survey, 94% of radiologists felt that peer review was worthwhile, 90% reported that the scores they received were appropriate and 78% felt that the received feedback was valuable.
  
  
  CONCLUSIONS
  Workstation-based peer review can increase completion rates and levels of radiologist acceptance while producing RADPEER scores similar to those previously reported. This approach may be one way to increase radiologist engagement in peer review quality assurance.
authors.affiliation: Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada Medical Imaging Consultants, 11010-101 Street, Edmonton, Alberta, Canada T5H 4B9.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: O'Keeffe
authors.affiliation: Intelerad, Montreal, Quebec, Canada Present address: 295 Midpark Way SE, Suite 380, Calgary, Alberta, Canada T2X 2A8.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Davis
authors.affiliation: Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada Medical Imaging Consultants, 11010-101 Street, Edmonton, Alberta, Canada T5H 4B9.
authors.forename: Kerry
authors.initials: K
authors.lastname: Siminoski
mesh_terms: D002983:Clinical Competence; D006801:Humans; D018024:Peer Review, Health Care / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000458:organization & administration* / Q000592:standards; D011871:Radiology / Q000458:organization & administration* / Q000592:standards; D011897:Random Allocation; D012189:Retrospective Studies
keywords: consensus methods; human factors; medical errors; peer assessment; quality improvement; quality indicators