Thirty-one radiologists who had no knowledge of the clinical outcome or litigation did not confirm the expert witness interpretation. This finding prompts questions about the current method of determining standard of care in legal cases, that is, use of paid medical expert witnesses. Our findings suggest that use of radiologists blinded to clinical outcome may be a more objective method of evaluating legal cases.
The results of our study demonstrate a wide range of interpretation, with wider ranges observed in more complex cases and with vague clinical complaints. Comparison to the primary reader required the use of aggregate analysis and an agreement percentage cutoff to minimize bias and the limitations of this type of study. An intensive evaluation of radiologist performance such as this could be considered in various settings such as a quality assurance program, intense scrutiny of an individual radiologist whether competency is in question, or for medicolegal purpose to ascertain standard of care.
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