Zhou Shannon, Hanna Tarek, Ma Tianwen, Johnson Timothy D, Lamoureux Christine, Weber Scott, Johnson Jamlik-Omari, Steenburg Scott D, Dunkle Jeffrey W, Chong Suzanne T
Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN, USA.
Emergency and Trauma Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA.
Emerg Radiol. 2023 Oct;30(5):607-612. doi: 10.1007/s10140-023-02161-6. Epub 2023 Jul 31.
To assess the influence of time of day when a study is interpreted on discrepancy rates for common and advanced studies performed in the acute community setting.
This retrospective study used the databank of a U.S. teleradiology company to retrieve studies between 2012 and 2016 with a preliminary report followed by a final report by the on-site client hospital. Neuroradiology, abdominal radiology, and musculoskeletal radiology studies were included. Teleradiologists were fellowship trained in one of these subspecialty areas. Daytime, evening, and overnight times were defined. Associations between major and minor discrepancies, time of day, and whether the study was common or advanced were tested with significance set at p = .05.
A total of 5,883,980 studies were analyzed. There were 8444 major discrepancies (0.14%) and 17,208 minor discrepancies (0.29%). For common studies, daytime (0.13%) and evening (0.13%) had lower major discrepancy rates compared to overnight (0.14%) (daytime to overnight, RR = 0.57, 95%CI: 0.45, 0.72, p < 0.01 and evening to overnight, RR = 0.57, 95%CI: 0.49,0.67, p < 0.01). Minor discrepancy rates for common studies were decreased for evening (0.29%) compared to overnight (0.30%) (RR = 0.89, 95%CI: 0.80,0.99, p = 0.029). For advanced studies, daytime (.15%) had lower major discrepancy rates compared to evening (0.20%) and overnight (.23%) (daytime to evening, RR = 0.77, 95%CI: 0.61, 0.97, p = 0.028 and daytime to overnight, RR = 0.66, 95%CI: 0.50, 0.87, p ≤ 0.01).
Significantly higher major discrepancy rates for studies interpreted overnight suggest the need for radiologists to exercise greater caution when interpreting studies overnight and may require practice management strategies to help optimize overnight work conditions. The lower major discrepancy rates on advanced studies interpreted during the daytime suggest the need for reserving advanced studies for interpretation during the day when possible.
评估在急性社区环境中进行的普通和高级检查报告解读时间对差异率的影响。
这项回顾性研究使用了一家美国远程放射学公司的数据库，检索2012年至2016年间的检查报告，这些报告先有初步报告，随后由现场客户医院出具最终报告。纳入神经放射学、腹部放射学和肌肉骨骼放射学检查。远程放射科医生在这些亚专业领域之一接受过专科培训。定义了白天、晚上和夜间时段。对主要和次要差异、报告解读时间以及检查是普通还是高级之间的关联进行了检验，显著性设定为p = 0.05。
共分析了5,883,980份检查报告。有8444个主要差异（0.14%）和17,208个次要差异（0.29%）。对于普通检查，白天（0.13%）和晚上（0.13%）的主要差异率低于夜间（0.14%）（白天与夜间相比，RR = 0.57，95%CI：0.45, 0.72，p < 0.01；晚上与夜间相比，RR = 0.57，95%CI：0.49, 0.67，p < 0.01）。普通检查的次要差异率在晚上（0.29%）低于夜间（0.30%）（RR = 0.89，95%CI：0.80, 0.99，p = 0.029）。对于高级检查，白天（0.15%）的主要差异率低于晚上（0.20%）和夜间（0.23%）（白天与晚上相比，RR = 0.77，95%CI：0.61, 0.97，p = 0.028；白天与夜间相比，RR = 0.66，95%CI：0.50, 0.87，p ≤ 0.01）。
夜间解读的检查报告主要差异率显著更高，这表明放射科医生在夜间解读检查报告时需要更加谨慎，可能需要实施实践管理策略来优化夜间工作条件。白天解读的高级检查报告主要差异率较低，这表明可能需要尽可能将高级检查安排在白天进行解读。
