From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (A.G.P., V.J.P., C.D.J., M.D.P.); and Department of Health Science Research, Section of Biostatistics, Mayo Clinic Arizona, Scottsdale, Ariz (N.Z.).
Radiology. 2020 Nov;297(2):374-379. doi: 10.1148/radiol.2020201558. Epub 2020 Aug 18.
Background There is increasing research attention on the impact of overnight work on radiologist performance. Prior studies on overnight imaging interpretive errors have focused on radiology residents, not on the relative performance of board-eligible or board-certified radiologists at night compared with during the day. Purpose To analyze the rate of clinically important interpretation errors on CT examinations of the abdomen, pelvis, or both ("body CT studies") committed by radiology fellows working off-hours based on day or night assignment. Materials and Methods Between July 2014 and June 2018, attending physicians at one tertiary care institution reviewed all body CT studies independently interpreted off-hours by radiologists in an academic fellowship within 10 hours of initial interpretation. Discrepancies affecting acute or follow-up clinical care were classified as errors. In this retrospective study, the error rate for studies interpreted during the day (between 7:00 am and 5:59 pm) was compared with that of studies interpreted at night (between 6:00 pm and 6:59 am). Error rate in the first half of day and night assignments was compared with error rate in the latter half. Statistical analyses used χ tests and general estimating equations; significance was defined as < .05. Results There were 10 090 body CT studies interpreted by 32 radiologists. Forty-four of 2195 daytime studies (2.0%) had errors compared with 240 of 7895 nighttime studies (3.0%; = .02). Twenty-two of 32 (69%) radiologists had higher error rates for night cases ( = .03). There were more errors in the last half of a night assignment (125 of 3358, 3.7%; = .002) compared with the first half (115 of 4537, 2.5%). Conclusion On the basis of a subspecialty review, clinically important off-hours body CT interpretation errors occurred more frequently overnight and more frequently in the latter half of assignments, with more radiologists having worse error rates at night compared with the day. © RSNA, 2020 See also the editorial by Bruno in this issue.
背景 越来越多的研究关注夜班对放射科医生绩效的影响。先前关于夜间影像学解读错误的研究集中在住院医师身上，而不是在夜间与白天相比，有资格或有资格认证的放射科医生的相对表现。
目的 基于班次分配，分析放射科住院医师在轮班期间进行的腹部、骨盆或两者的 CT 检查（“体部 CT 研究”）中出现临床重要解读错误的比率。
材料与方法 在 2014 年 7 月至 2018 年 6 月期间，一家三级保健机构的主治医生在初始解释后 10 小时内，独立审查了由学术奖学金中的放射科医生在轮班期间解释的所有体部 CT 研究。影响急性或随访临床护理的差异被归类为错误。在这项回顾性研究中，白天（上午 7:00 至下午 5:59）解释的研究的错误率与夜间（下午 6:00 至上午 6:59）解释的研究的错误率进行了比较。比较了前半夜和后半夜任务的错误率。统计分析采用 χ2 检验和广义估计方程；显著性定义为 ＜.05。
结果 共有 32 名放射科医生对 10090 个体部 CT 研究进行了分析。2195 例日间研究中有 44 例（2.0%）有错误，7895 例夜间研究中有 240 例（3.0%； =.02）。22 名（69%）放射科医生的夜间病例错误率更高（ =.03）。夜间后半段的错误率更高（3358 例中有 125 例，3.7%； =.002），而前半段的错误率（4537 例中有 115 例，2.5%）。
结论 根据一项专业审查，夜间体部 CT 解读错误更频繁地发生，且更频繁地发生在后半段，与白天相比，夜间有更多的放射科医生出现错误率更高。
