Strub William M, Vagal Achala A, Tomsick Thomas, Moulton Jonathan S
Department of Radiology, University of Cincinnati, 234 Goodman Street ML 0761, Cincinnati, OH 45267, USA.
Emerg Radiol. 2006 Oct;13(1):19-23. doi: 10.1007/s10140-006-0498-4. Epub 2006 Jul 25.
We report our experience with resident preliminary interpretations given at night on both abdominal and neurological CT scans to quantify the discrepancy rate when compared to the final report. An attempt was also made to document any adverse clinical outcomes as a result of the preliminary interpretation. From January 1, 2004 to December 31, 2004, adult CT examinations were prospectively interpreted by residents at night at a level I trauma center. Both the neurological and body CT scans were reviewed beginning at 7:00 a.m. the following morning by the respective subspecialty staff and discrepancies were noted. Adult CT examinations (6,858) were prospectively interpreted by residents: 5,206 cranial spinal CT examinations and 1,652 body CT examinations. Among the neurological studies, there were six cases identified as major discrepancies (0.1%) and 185 minor discrepancies (3.5%). Among the body CT cases, there were seven cases identified as major discrepancies (0.4%) and 23 cases of minor discrepancies (1.4%). There is a low discrepancy rate (0.2% major and 3.1% minor) in the preliminary resident interpretations from the final report. The process of overnight preliminary CT interpretations should continue as it is not substandard care.
我们报告了住院医师在夜间对腹部和神经科CT扫描进行初步解读的经验，以量化与最终报告相比的差异率。我们还尝试记录因初步解读而导致的任何不良临床结果。从2004年1月1日至2004年12月31日，在一家一级创伤中心，住院医师对成人CT检查进行夜间前瞻性解读。次日上午7点开始，由相应的专科工作人员对神经科和身体部位的CT扫描进行复查，并记录差异情况。住院医师对成人CT检查（6858例）进行了前瞻性解读：5206例颅脑脊髓CT检查和1652例身体部位CT检查。在神经科检查中，有6例被确定为重大差异（0.1%），185例为轻微差异（3.5%）。在身体部位CT检查中，有7例被确定为重大差异（0.4%），23例为轻微差异（1.4%）。住院医师初步解读与最终报告之间的差异率较低（重大差异0.2%，轻微差异3.1%）。夜间CT初步解读的流程应继续，因为这并非不合格的医疗服务。
