title: Comparing Preliminary and Final Neuroradiology Reports: What Factors Determine the Differences?
abstract: OBJECTIVE
  Trainees' interpretations of neuroradiologic studies are finalized by faculty neuroradiologists. We aimed to identify the factors that determine the degree to which the preliminary reports are modified.
  
  
  METHODS
  The character length of the preliminary and final reports and the percentage character change between the 2 reports were determined for neuroradiology reports composed during November 2012 to October 2013. Examination time, critical finding flag, missed critical finding flag, trainee level, faculty experience, imaging technique, and native-versus-non-native speaker status of the reader were collected. Multivariable linear regression models were used to evaluate the association between mean percentage character change and the various factors.
  
  
  RESULTS
  Of 34,661 reports, 2322 (6.7%) were read by radiology residents year 1; 4429 (12.8%), by radiology residents year 2; 3663 (10.6%), by radiology residents year 3; 2249 (6.5%), by radiology residents year 4; and 21,998 (63.5%), by fellows. The overall mean percentage character change was 14.8% (range, 0%-701.8%; median, 6.6%). Mean percentage character change increased for a missed critical finding (+41.6%,P< .0001), critical finding flag (+1.8%,P< .001), MR imaging studies (+3.6%,P< .001), and non-native trainees (+4.2%,P= .018). Compared with radiology residents year 1, radiology residents year 2 (-5.4%,P= .002), radiology residents year 3 (-5.9%,P= .002), radiology residents year 4 (-8.2%,P< .001), and fellows (-8.7%;P< .001) had a decreased mean percentage character change. Senior faculty had a lower mean percentage character change (-6.88%,P< .001). Examination time and non-native faculty did not affect mean percentage character change.
  
  
  CONCLUSIONS
  A missed critical finding, critical finding flag, MR imaging technique, trainee level, faculty experience level, and non-native-trainee status are associated with a higher degree of modification of a preliminary report. Understanding the factors that influence the extent of report revisions could improve the quality of report generation and trainee education.
authors.affiliation: From The Russell H. Morgan Department of Radiology and Radiological Sciences (K.S., M. Cohen, G.S., P.G.N., J.S.L., D.M.Y., L.S.B.), Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: K
authors.identifier: http://orcid.org/0000-0001-6143-1750
authors.initials: K
authors.lastname: Stankiewicz
authors.affiliation: From The Russell H. Morgan Department of Radiology and Radiological Sciences (K.S., M. Cohen, G.S., P.G.N., J.S.L., D.M.Y., L.S.B.), Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: M
authors.identifier: http://orcid.org/0000-0003-4103-201X
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Department of Biostatistics, University of Washington (M. Carone), Seattle, Washington.
authors.forename: M
authors.identifier: http://orcid.org/0000-0003-2106-0953
authors.initials: M
authors.lastname: Carone
authors.affiliation: From The Russell H. Morgan Department of Radiology and Radiological Sciences (K.S., M. Cohen, G.S., P.G.N., J.S.L., D.M.Y., L.S.B.), Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: G
authors.identifier: http://orcid.org/0000-0003-2594-8685
authors.initials: G
authors.lastname: Sevinc
authors.affiliation: From The Russell H. Morgan Department of Radiology and Radiological Sciences (K.S., M. Cohen, G.S., P.G.N., J.S.L., D.M.Y., L.S.B.), Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: P G
authors.identifier: http://orcid.org/0000-0001-5108-7749
authors.initials: PG
authors.lastname: Nagy
authors.affiliation: From The Russell H. Morgan Department of Radiology and Radiological Sciences (K.S., M. Cohen, G.S., P.G.N., J.S.L., D.M.Y., L.S.B.), Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: J S
authors.identifier: http://orcid.org/0000-0002-8935-3683
authors.initials: JS
authors.lastname: Lewin
authors.affiliation: From The Russell H. Morgan Department of Radiology and Radiological Sciences (K.S., M. Cohen, G.S., P.G.N., J.S.L., D.M.Y., L.S.B.), Johns Hopkins Medical Institutions, Baltimore, Maryland dyousem1@jhu.edu.
authors.forename: D M
authors.identifier: http://orcid.org/0000-0002-1222-6643
authors.initials: DM
authors.lastname: Yousem
authors.affiliation: From The Russell H. Morgan Department of Radiology and Radiological Sciences (K.S., M. Cohen, G.S., P.G.N., J.S.L., D.M.Y., L.S.B.), Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: L S
authors.identifier: http://orcid.org/0000-0001-8221-4819
authors.initials: LS
authors.lastname: Babiarz