Ronald Scott Winokur MD, Presenter: Nothing to Disclose

Richard Earnest Sharpe MD, MBA, Abstract Co-Author: Nothing to Disclose

Richard Joseph Thomas Gorniak MD, Abstract Co-Author: Consultant, Bracco Group

Levon N. Nazarian MD, Abstract Co-Author: Nothing to Disclose

Adam E. Flanders MD, Abstract Co-Author: Research Consultant, Geron Corporation

Vijay Madan Rao MD, Abstract Co-Author: Nothing to Disclose

Analysis of report changes required to finalize a resident preliminary report can delineate variations in report edits as well as quantify attending report editing behaviors. When variations are expressed relative to one’s peers, outliers may benefit from knowing their variation from the norm to modify their workflow or knowledge.

Radiology residents generate preliminary reports that are later reviewed, edited and approved by the attending staff. These edits are not typically analyzed. However, quantitative analysis of these edits could provide valuable information regarding resident education and attending productivity.

We created an automated system for analyzing differences between resident preliminary and attending finalized radiology reports. Report changes were analyzed using open source document comparison software. Levenshtein Distance (LD), the number of changes required to convert a preliminary report to the final report, was calculated. The Levenshtein Percent (LP), (LD)/(final report character length), was calculated to normalize for report length. A grid was created which displayed ALPs for each possible resident/attending pair plotted in order of decreasing ALP for all reports in a given time interval.

A number of factors contribute to the frequency of changes made to a preliminary report that involve communication, education, compulsiveness, work ethic and efficiency. These metrics provides a single visual aid that helps to identify outlier trainees and attendings as well as potential synergies where an ideal team of trainee/attending can work most efficiently. The metrics can also be used as a method to augment or defend resident evaluations particularly in the instance where the attending proves to be an outlier. Resident outliers could analyze reports to discern whether excessive edits could be remedied by improved report writing or clinical knowledge. Likewise, attendings with unusually high LPs independent of trainee may be focused principally on stylistic alterations rather than changes in content. 

Winokur, R, Sharpe, R, Gorniak, R, Nazarian, L, Flanders, A, Rao, V, Grid of Attending-Resident Report Pairs Provides Valuable Feedback for Resident and Attending Performance in Relation to Their Peers.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11013615.html