Ivan Christopher Davis MD, Presenter: Nothing to Disclose

James R. Sancrant DO, Abstract Co-Author: Nothing to Disclose

Bahram Kiani MD, Abstract Co-Author: Nothing to Disclose

Leon Lenchik MD, Abstract Co-Author: Nothing to Disclose

1) Determine the discrepancy rates in the radiology residents’ interpretations of musculoskeletal radiographs from the emergency department. 2) Determine the impact of the resident training level and the examination type on the discrepancy rate, for purposes of improved resident education.

We conducted a review of radiology reports on all musculoskeletal radiographs obtained between 1/1/2007 and 2/31/2012 at a Level 1 Emergency Department. A total of 128,684 exams were interpreted, of which 25,575 were from pediatric and 103,109 from adult patients. Discrepancy rate between preliminary resident reports and final attending reports was determined by the change of report statement mandated by our department policy. The change of report rate was compared based on resident training level and exam type (pediatric vs. adult; anatomic site).

The types of exams were: pelvis (12%), spine (10%), knee (10%), hand (8%), ankle (8%), foot (7%), shoulder (6%), elbow (6%), wrist (6%), forearm (5%), thumb (5%), leg (5%), hip (4%), femur (4%), humerus (3%), finger (1%), other (<1%). 25% of exams were read by first year (Y1), 61% by second year (Y2), 10% by third year (Y3), and 4% by fourth year (Y4) residents. The overall change of report rate (CRR) was 0.55%. CRR was 1.01% for pediatric exams and 0.43% for adult exams. For pediatric exams, CRR was 1.04% for Y1, 1.01% for Y2, 0.58% for Y3, and 1.55% for Y4 residents. For adult exams, CRR was 0.51% for Y1, 0.41% for Y2, 0.39% for Y3, and 0.35% for Y4 residents. Pediatric exams with the highest CRR were: skeletal survey (5.53%), thumb (1.82%), and hand (1.73%). Adults exams with the highest CRR were: sacrum (1.37%), foot (0.70%), and shoulder (0.65%).

1) Discrepancy rates in radiology residents’ interpretations are low. 2) Discrepancy rates decrease with increasing resident training level, except for fourth year residents interpreting pediatric exams. Discrepancy rates are higher for pediatric exams and highest for less common exam types.

Resident discrepancy rate is dependent on exam type and resident level of training. These factors should be considered during resident education.

Davis, I, Sancrant, J, Kiani, B, Lenchik, L, Discrepancy Rate between Radiology Residents and Radiology Attendings for Musculoskeletal Radiographs from a Level 1 Emergency Department.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12031363.html