Orejuela-Zapata Juan Felipe, Mejía-Quiñones Valentina, Granados-Sánchez Ana María
Fundación Valle del Lili, Departamento de Radiología e Imágenes Diagnósticas, Av. Simón Bolívar - Carrera 98 # 18-49, Cali, Colombia.
Fundación Valle del Lili, Centro Investigaciones Clínicas, Cali, Colombia.
Heliyon. 2023 Jul 27;9(8):e18714. doi: 10.1016/j.heliyon.2023.e18714. eCollection 2023 Aug.
Residents usually cover night and weekend shifts issuing the preliminary reading of radiological studies in university hospitals. This is essential to strengthening decision-making skills when facing complex cases independently. However, there should be a balance between patient safety and academic experience since some concern has been expressed about the accuracy of the interpretations generated by trainees. This work aims to evaluate and characterize the discrepancies in preliminary reports issued by radiology residents.
Radiologists filled out a questionnaire to evaluate preliminary reports of trainees considering diagnosis, findings description, clinical approach changes, and critical findings. Analysis was performed considering modality, imaging type, body part, and resident academic year. A Chi-square test with a significance level α of 0.05 was used to make group comparisons.
A total of 9072 studies were reviewed. Major and minor overall discrepancy rates were 1.7% and 8.3%, respectively. Minor discrepancy rate, findings description, and critical findings identification improved with increasing academic year, both overall and by modality. Discrepancy rates were lower for CT than MR and neuroimaging than for body-imaging studies. The highest major and minor discrepancy rates as abdomen/pelvis CT and lumbar-spine MR, respectively. Two percent of reports presented discrepancies that could generate a medical approach change.
Discrepancy rates are low and comparable with those reported in the literature. These rates tend to improve as the resident's academic year increases. Our results suggest that radiology residents' coverage of night shifts and weekends is a practice that benefits the educational process without negatively impacting patient safety.
在大学医院，住院医师通常要负责夜间和周末值班，并出具放射学检查的初步诊断报告。这对于独立面对复杂病例时增强决策能力至关重要。然而，鉴于有人对实习医生所做解读的准确性表示担忧，在患者安全和学术经验之间应取得平衡。本研究旨在评估和描述放射科住院医师出具的初步报告中的差异。
放射科医生填写一份问卷，以评估实习医生的初步报告，内容包括诊断、检查结果描述、临床处理方式的改变以及关键检查结果。分析时考虑了检查方式、成像类型、身体部位以及住院医师的学年。采用显著性水平α为0.05的卡方检验进行组间比较。
共审查了9072份检查报告。总体主要差异率和次要差异率分别为1.7%和8.3%。随着学年增加，总体及按检查方式划分的次要差异率、检查结果描述和关键检查结果识别情况均有所改善。CT检查的差异率低于MR检查，神经影像学检查的差异率低于身体影像学检查。腹部/盆腔CT和腰椎MR的主要和次要差异率分别最高。2%的报告存在可能导致临床处理方式改变的差异。
差异率较低，与文献报道相当。随着住院医师学年增加，这些差异率往往会有所改善。我们的结果表明，放射科住院医师参与夜间和周末值班对教育过程有益，且不会对患者安全产生负面影响。
