Addenda to the radiology report: what are we trying to convey?

PURPOSE

The aims of this paper are to describe addenda to radiology reports and to discuss the communication gaps in radiology addenda reaching referring physicians. The authors examine impediments to compliance with an addendum policy and suggest possible solutions.

METHODS

A total of 62,500 radiology reports were reviewed to analyze the occurrence of report addenda. Addenda types were separated into clinical, generated by radiologists, and administrative (for billing or regulatory reasons). Two radiologists reviewed all clinical addenda and classified them as significant or not significant. Significant addenda were further analyzed for various aspects. An e-mail survey was also conducted to assess prevailing practices in academic departments of radiology.

RESULTS

There were 1,069 reports with addenda (1.7%). Of these, 575 were generated by radiologists. Forty-nine (8.5%) were for clinically significant errors and 526 (91.5%) were not. Of the 49 significant addenda, 9 (18%) were fully compliant with departmental addendum policies, 27 (55%) were noncompliant, and 13 (27%) were partially compliant. Of the 49 clinically significant addenda, 17 (55%) were dictated within 1 hour and 40 (82%) within 24 hours of the finalized original reports.

CONCLUSIONS

Poor compliance with an addendum policy was found. The reasons for noncompliance and possible remedies are discussed, with the hope of beginning a dialogue in the radiology literature on the risks of poor communication processes and the benefits of full implementation of well thought-out addendum policies.