Eduard Michel MD, Presenter: Officer, Virtual Radiologic Corporation Shareholder, Virtual Radiologic Corporation

Julie Shields, Abstract Co-Author: Employee, Virtual Radiologic Corporation

There are very limited reports on radiologists’ accuracy rates. A recent report addressing this issue quotes an accuracy rate for a teleradiology practice at 98.9% (Wong et al, 2005). The current study which includes almost 5 million interpretations over a 3-year period demonstrates overall accuracy rates for preliminary interpretations of 99.8%. Factors that may contribute to higher accuracy than in prior reports and which will be discussed include extensive screening of radiologists, efficient workflow and dedicated support staff

To evaluate the accuracy of interpretations by teleradiologists in a double read environment and compare accuracy rates among various imaging modalities

All preliminary studies interpreted by Virtual Radiologic (vRad) radiologists between January 1, 2007 and December 31, 2009 were included in this study. Each case was double read by an independent, local radiologist who provided the final interpretation. Those cases for which the final interpretation differed from the preliminary interpretation were submitted to the vRad QA committee (QAC) for further review. Each discrepant case was graded for severity of the misdiagnosis and impact on patient care. The results were tabulated and each case was assigned to a modality and body part category

A total of 4,879,715 preliminary radiological studies were interpreted between 1/1/2007 and 12/31/2009. Discrepancy reports were received for 17,429 cases (0.36%). Of these, the QAC categorized 4.944 cases (0.10%) as “no QA” and 2,269 cases (0.05%) as “non-significant” (incidental findings/minor typographical errors). The remaining 10,216 cases were categorized as true discrepancies. Minor discrepancies with no impact on patient care represented 2,879 cases (0.06% of all cases and 28.2% of all discrepancies), minor discrepancies with impact on patient care represented 4,493 cases (0.09% of cases and 44.0% of all discrepancies) and significant discrepancies represented 2,844 cases (0.06% of all cases and 27.8% of all discrepancies). The overall incidence of discrepancies was 0.209%, ranging from 0.091% for ultrasound studies to 0.615% for nuclear medicine studies

Michel, E, Shields, J, Longitudinal Study of Quality Metrics: A 2 Year Retrospective Analysis of 4.9 Million Interpretations in a Teleradiology Practice.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9016125.html