Discrepancies in Radiograph Interpretation Between Pediatric Radiologists and Pediatric Intensivists in the Pediatric or Neonatal Intensive Care Unit
| Autor: | Eliza H. Myers, Suhas Nafday, Kandi George, Mark C. Liszewski, Mark Shlomovich, Sheri L. Nemerofsky, Einat Blumfield, Adam Z. Fink, K. Allen Eddington, H. Michael Ushay, Terry L. Levin |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Neonatal intensive care unit Radiography Pediatric Radiologist Atelectasis Intensive Care Units Pediatric Pediatrics 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Intensive Care Units Neonatal Intensive care Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies Diagnostic Errors Child Prospective cohort study Observer Variation business.industry Infant Newborn Infant Hospitals Pediatric medicine.disease Patient management Child Preschool Emergency medicine Female Clinical Competence Radiology business Neonatal lung 030217 neurology & neurosurgery |
| Zdroj: | Journal of the American College of Radiology. 15:1580-1586 |
| ISSN: | 1546-1440 |
| DOI: | 10.1016/j.jacr.2017.12.007 |
| Popis: | Background In pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs), patient management decisions are sometimes based on preliminary interpretations of radiographs by pediatric intensivists (PIs) before a formal interpretation by a pediatric radiologist (PRs). Objective To quantify and classify discrepancies in radiographic interpretation between PRs and PIs in the PICU and NICU. Materials and Methods This institutional review board–approved multi-institutional prospective study included three PRs and PIs at two PICUs and three NICUs. Interpretations of chest and abdominal radiographs by PIs and PRs were recorded on online forms and compared. Discrepancies in interpretations were classified as "miss," "misinterpretation," or "overcall." The discrepancies were also categorized as "actionable" or "nonactionable" based on extrapolation of the ACR actionable reporting work group's list of actionable findings. Results In 960 radiographic interpretations, the total, nonactionable, and actionable discrepancy rates between PRs and PIs were 34.7%, 26.8%, and 7.9%, respectively. The most common actionable discrepancies were line or tube positions and identification and interpretation of parenchymal opacities in the lungs. Identification of air leaks in the PICU and differentiation of normal from abnormal bowel gas patterns in the NICU followed in frequency. Air leaks accounted for 1% of total discrepancies and 11% of actionable discrepancies. Most discrepancies were nonactionable and included retrocardiac atelectasis and mischaracterization of neonatal lung disease in the PICU and NICU, respectively. Conclusion Although the total discrepancy rate was high, most discrepancies were nonactionable. Actionable discrepancies were predominantly due to line and tube position, which should be an area of focused education. |
| Databáze: | OpenAIRE |
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