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Congress: ECR25
Poster Number: C-20435
Type: Poster: EPOS Radiologist (educational)
Authorblock: D. I. Krimli, S. Shihata, A. A. Felemban, M. I. Alsayed, O. H. Alaslani, B. A. Bannan, Z. Alsabban, Z. Zia; Jeddah/SA
Disclosures:
Danah Ismail Krimli: Nothing to disclose
Salah Shihata: Nothing to disclose
Abdulbari Abdulkaliq Felemban: Nothing to disclose
Mohammed Ibrahim Alsayed: Nothing to disclose
Ohoud Hameed Alaslani: Nothing to disclose
Badr Abdulmajied Bannan: Nothing to disclose
Zehour Alsabban: Nothing to disclose
Zergham Zia: Nothing to disclose
Keywords: Abdomen, Cardiovascular system, Emergency, CT, MR, Ultrasound, Computer Applications-Detection, diagnosis, Quality assurance
Learning objectives To determine the discrepancy rates and clinical significance of differences between provisional radiology resident reports and final consultant interpretations in emergency on-call studies. To assess the clinical significance of these discrepancies and the interviewer variability, using the RadPeer scoring system. The findings seek to enhance radiology education, peer review process, and quality assurance in emergency imaging.
Read more Background A retrospective review of all emergency on-call studies at a tertiary care institution over 8 weeks was conducted. Inclusion criteria included after-hours emergency cases with finalized report changes, while outpatient or inpatient studies were excluded.  The Automated Critical Result Notification System (ACRNS) flagged discrepancies between provisional and finalized reports. Four board-certified radiologists independently reviewed cases using the 2016 ACR RadPeer scoring system, which categorizes discrepancies as follows:   1: Concurrence.   2a/3a: Non-significant discrepancy (e.g., stable postoperative changes).   2b/3b: Clinically significant discrepancy...
Read more Findings and procedure details 1. Discrepancy Rates Between Provisional and Finalized Reports of 1,367 emergency studies, 70 (5.1%) exhibited discrepancies between provisional resident reports and finalized consultant interpretations. These discrepancies were distributed across imaging modalities as follows:   CT: 56/874 (6.4%)   MRI: 4/89 (4.5%)   US: 10/402 (2.5%)    2. Clinical Significance Determined by RadPeer Reviewer Scores  The clinical significance of each discrepancy was independently assessed by two board-certified radiologists using the ACR 2016 RadPeer scoring system, which categorizes discrepancies based on their potential impact on patient...
Read more Conclusion This study highlights two critical findings:   Low Discrepancy Rate: Only 5.1% of provisional reports required modification, demonstrating high concordance with final interpretations. Persistent Inter-Reviewer Variability: 20% disagreement in RadPeer scoring, particularly in neuroimaging, underscores the need for standardized training. These results reinforce the value of resident preliminary reports in emergency care while emphasizing opportunities to refine peer-review processes. The 64.3% significant discrepancy rate determined by independent reviewers emphasizes the need for structured training to standardize RadPeer applications, particularly in high-risk domains like...
Read more References 1. Bruno MA, Walker EA, Abujudeh HH. Understanding and confronting our mistakes: The epidemiology of error in radiology and strategies for error reduction. Radiographics. 2015;35(6):1668–76. doi:10.1148/rg.2015150023.2. Hawkins CM, Hall S, Zhang B, Towbin AJ. Measuring peer review performance: The impact of inter-rater reliability. J Am Coll Radiol. 2014;11(5):397–402. doi:10.1016/j.jacr.2013.10.021.3. Larson DB, Nance JJ. Rethinking peer review: What aviation can teach radiology about performance improvement. Radiology. 2011;259(3):626–32. doi:10.1148/radiol.10181619.4. Rosenkrantz AB, Gandhi D, Duszak R. Discrepancy rates and clinical impact of imaging...
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