Abstract
The purpose of this study was to establish practice patterns of radiology residents in regards to interpretation and reporting of outside studies for transferred patients. We performed a national survey of radiology residency chief residents, administered by email through the Association of Program Directors in Radiology (APDR). There were 81 chief resident respondents, representing 42.8 % of 187 total Accreditation Council for Graduate Medical Education (ACGME)-approved radiology residency training programs in the USA. In 97.5 % of programs, residents perform interpretations of outside studies. Up to 76.7 % of respondents state that when outside studies are reviewed by residents, an original report is available in less than one quarter of cases. While 55.1 % of respondents state that there is a mechanism for recording their findings and impressions for outside studies, only 32.1 % are aware of a policy requiring documentation. Of the respondents, 42.3 % report they have no means for documenting their findings and impressions on outside studies. Further, 65.4 % state that there is no policy requiring an attending to review and document agreement with their interpretation of outside studies. There is wide institutional variation in both policy and practice regarding reinterpretation of outside studies for patients transferred to academic hospitals. While the majority of radiology residents are providing the service of reinterpreting outside studies, only a minority of residency programs have a policy requiring (1) documentation of their impressions or (2) attending oversight and documentation of discrepant opinions.
Similar content being viewed by others
References
Broder J et al (2006) Increasing utilization of computed tomography in the adult emergency room 2000–2005. Emerg Radiol 13(1):25–30
Korley FK et al (2010) Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998–2007. JAMA 304(13):1465–1471
Larson DB et al (2011) National trends in CT use in the emergency department: 1995–2007. Radiology 258(1):164–173
(NHACS) National Hospital Ambulatory Care Survey: 2010 emergency department summary tables. http://www.cdc.gov/nchs/data/ahcd/nhamcs100ed_2010.pdf
Kindermann D, Mutter R, Pines JM (2013) Emergency department transfers to acute care facilities, 2009. Statistical Brief #151. Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality
Grogan MJ, Marn C (2011) My PQI Project—medical legal issues with outside trauma studies: are you opening yourself up to liability? J Am Coll Radiol 8:528–529
McNeeley MF, Gunn ML, Robinson JD (2013) Transfer patient imaging: current status, review of the literature, and the Harborview Experience. J Am Coll Radiol 10:361–367
Sodickson A, Opraseuth J, Ledbetter S (2011) Outside imaging in emergency department transfer patients: CD import reduces rates of subsequent imaging utilization. Radiology 260(2):408–413
Sung JC, Sodickson A, Ledbetter S (2009) Outside CT imaging among emergency department transfer patients. J Am Coll Radiol 6:626–632
Teshome G, Closson FT (2006) Emergency Medical Treatment and Labor Act: the basics and other medicolegal concerns. Pediatr Clin N Am 53:139–155
Zibulewsky J (2001) The Emergency Medical Treatment and Active Labor Act (EMTALA): what it is and what it means for physicians. Baylor Univ Med Cent Proc 14:339–346
Reis SP, Lefkowitz Z, Kaur S, Seiler M (2012) Interpretation of outside imaging studies: solutions from a tertiary care trauma center. JACR 9(8):591–594
Zan E, Yousem DM, Carone M, Lewin JS (2010) Second-opinion consultations in neuroradiology. Radiology 255:135–14
Bagg SA, Steenburg SD, Ravenel JG (2008) Handling of outside trauma studies: a survey of program directors. J Am Coll Radiol 5:657–663
ACGME Program Requirements for Graduate Medical Education in Diagnostic Radiology, II.B.1.b).(3); https://www.acgme.org/acgmeweb/Portals/0/PFAssets/2013-PR- FAQ-PIF/420_diagnostic_radiology_07012013.pdf
Robinson JD, McNeeley MF (2012) Transfer patient imaging: a survey of members of the American Society of Emergency Radiology. Emerg Radiol 19:447–454
Carney E, Kempf J, DeCarvalho V, Yudd A, Nosher J (2003) Preliminary interpretations of after-hours CT and sonography by radiology residents versus final interpretations by body imaging radiologists at a level 1 trauma center. AJR 181:367–373
Cooper VF, Goodhartz LA, Nemcek AA, Ryu RK (2008) Radiology resident interpretations of on-call imaging studies: the incidence of major discrepancies. Acad Radiol 15:1198–1204
Chung JH, Strigel RM, Chew AR, Albrecth E, Gunn ML (2009) Overnight resident interpretation of torso CT at a level 1 trauma center: an analysis and review of the literature. Acad Radiol 16:1155–1160
Lal NR, Murray UM, Eldevik OP, Desmond JS (2000) Clinical consequences of misinterpretations of neuroradiologic CT scans by on-call radiology residents. Am J Neuroradiol 21:124–129
Stevens KJ, Griffiths KL, Rosenberg J, Mahadevan S, Zatz LM, Leung ANC (2008) Discordance rates between preliminary and final radiology reports on cross-sectional imaging studies at a level 1 trauma center. Acad Radiol 15:1217–1226
Strub WM, Vagal AA, Tomsick T, Moulton JS (2006) Overnight resident preliminary interpretations on CT examinations: should the process continue? Emerg Radiol 13:19–23
Shih TH, Fan X (2008) Comparing response rates from web and mail surveys: a meta-analysis. Field Methods 20(3):249–271
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Swenson, D.W., Ellermeier, A., Dibble, E.H. et al. Review of outside studies by radiology residents: national survey of chief residents. Emerg Radiol 21, 479–484 (2014). https://doi.org/10.1007/s10140-014-1228-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10140-014-1228-y