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Evaluation of neuroradiology emergency MRI interpretations: low discrepancy rates between on-call radiology residents’ preliminary interpretations and neuroradiologists’ final reports

  • Emergency Radiology
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Abstract

Objectives

To evaluate the performance of on-call radiology residents in interpreting alone brain and spine MRI studies performed after hours, to describe their mistakes, and to identify influencing factors that increased the occurrence of errors.

Methods

A total of 328 MRI examinations performed during a 13-month period (from December 1, 2019, to January 1, 2021) were prospectively included. Discrepancies between the preliminary interpretation of on-call radiology residents and the final reports of attending neuroradiologists were noted and classified according to a three-level score: level 1 (perfect interpretation or minor correction), level 2 (important correction without immediate change in patient management), or level 3 (major correction with immediate change in patient management). Categorical data were compared using Fisher’s exact test.

Results

The overall discrepancy rate (level-2 and level-3 errors) was 16%; the rate of major discrepancies (only level-3 errors) was 5.5%. The major-discrepancy rate of second-year residents, when compared with that of senior residents, was significantly higher (p = 0.02). Almost all of the level-3 errors concerned cerebrovascular pathology. The most common level-2 errors involved undescribed aneurysms. We found no significant difference in the major-discrepancy rate regarding time since the beginning of the shift.

Conclusions

The great majority of examinations were correctly interpreted. The rate of major discrepancies in our study was comparable to the data in the literature, and there was no adverse clinical outcome. The level of residency has an effect on the rate of serious errors in residents’ reports.

Key Points

• The rate of major discrepancies between preliminary MRI interpretations by on-call radiology residents and final reports by attending neuroradiologists is low, and comparable to discrepancy rates reported for head CT interpretations.

• The youngest residents made significantly more serious errors when compared to senior residents.

• There was no adverse clinical outcome in patient morbidity as a result of an initial misdiagnosis.

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Abbreviations

CT:

Computed tomography

MRI:

Magnetic resonance imaging

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Funding

The authors state that this work has not received any funding.

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Authors

Corresponding author

Correspondence to Diana Salca.

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Guarantor

The scientific guarantor of this publication is Stéphane KREMER, MD, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because patient consent was waived.

Approval from the institutional animal care committee was not required (not concerned).

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Institutional review board approval was not required because patient consent was waived in our study.

Methodology

• Prospective

• Observational

• Performed at one institution

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Salca, D., Lersy, F., Willaume, T. et al. Evaluation of neuroradiology emergency MRI interpretations: low discrepancy rates between on-call radiology residents’ preliminary interpretations and neuroradiologists’ final reports. Eur Radiol 32, 7260–7269 (2022). https://doi.org/10.1007/s00330-022-08789-1

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  • DOI: https://doi.org/10.1007/s00330-022-08789-1

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