Balthazar Patricia, Konstantopoulos Christina, Wick Carson A, DeSimone Ariadne K, Tridandapani Srini, Simoneaux Stephen, Applegate Kimberly E
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Rm D125A, Atlanta, GA 30322.
2 Meharry Medical College, Nashville, TN.
AJR Am J Roentgenol. 2017 Nov;209(5):976-981. doi: 10.2214/AJR.17.18339. Epub 2017 Aug 4.
The purpose of this study was to evaluate the impact of trainee involvement and other factors on addendum rates in radiology reports.
This retrospective study was performed in a tertiary care pediatric hospital. From the institutional radiology data repository, we extracted all radiology reports from January 1 to June 30, 2016, as well as trainee (resident or fellow) involvement, imaging modality, patient setting (emergency, inpatient, or outpatient), order status (routine vs immediate), time of interpretation (regular work hours vs off-hours), radiologist's years of experience, and sex. We grouped imaging modalities as advanced (CT, MRI, and PET) or nonadvanced (any modality that was not CT, MRI, or PET) and radiologist experience level as ≤ 20 years or > 20 years. Our outcome measure was the rate of addenda in radiology reports. Statistical analysis was performed using multivariate logistic regression.
From 129,033 reports finalized during the study period, 418 (0.3%) had addenda. Reports generated without trainees were 12 times more likely than reports with trainee involvement to have addenda (odds ratio [OR] = 12.2, p < 0.001). Advanced imaging studies were more likely than nonadvanced studies to be associated with addendum use (OR = 4.7, p < 0.001). Reports generated for patients in emergency or outpatient settings had a slightly higher likelihood of addendum use than those in an inpatient setting (OR = 1.5, p = 0.04; and OR = 1.3, p = 0.04, respectively). Routine orders had a slightly higher likelihood of addendum use compared with immediate orders (OR = 1.3, p = 0.01). We found no difference in addendum use by radiologist's sex, radiologist's years of experience, emergency versus outpatient setting, or time of interpretation.
Trainees may add value to patient care by decreasing addendum rates in radiology reports.
本研究旨在评估学员参与及其他因素对放射学报告补遗率的影响。
本回顾性研究在一家三级护理儿科医院进行。从机构放射学数据存储库中，我们提取了2016年1月1日至6月30日期间的所有放射学报告，以及学员（住院医师或研究员）的参与情况、成像方式、患者类型（急诊、住院或门诊）、医嘱状态（常规与紧急）、解读时间（正常工作时间与非工作时间）、放射科医生的工作年限及性别。我们将成像方式分为先进（CT、MRI和PET）或非先进（任何非CT、MRI或PET的方式），并将放射科医生的经验水平分为≤20年或>20年。我们的观察指标是放射学报告的补遗率。使用多因素逻辑回归进行统计分析。
在研究期间最终确定的129,033份报告中，418份（0.3%）有补遗。没有学员参与生成的报告有补遗的可能性是有学员参与报告的12倍（比值比[OR]=12.2，p<0.001）。先进成像研究比非先进研究更有可能使用补遗（OR=4.7，p<0.001）。为急诊或门诊患者生成的报告使用补遗的可能性略高于住院患者（OR分别为1.5，p=0.04；和OR为1.3，p=0.04）。常规医嘱使用补遗的可能性略高于紧急医嘱（OR=1.3，p=0.01）。我们发现放射科医生的性别、工作年限、急诊与门诊类型或解读时间对补遗使用没有差异。
学员可能通过降低放射学报告的补遗率为患者护理增添价值。
