Is There Value in Having Radiology Provide a Second Reading in Pediatric Orthopaedic Clinic?

Natarajan, Vivek; Bosch, Patrick; Dede, Özgür; Deeney, Vincent F.; Mendelson, Stephen; Ward, Timothy J.; Brooks, Maria M.; Kenkre, Tanya S.; Roach, James W.

doi:10.1097/bpo.0000000000000917

Cited by 7 publications

(5 citation statements)

References 7 publications

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“…11 More recently, a retrospective review found that only 1% of radiology reports added new, clinically useful information in a paediatric orthopaedic clinic. 12 Our study demonstrated that only 10% of surgeons consult the formal radiology report for plain radiographs. A factor may be the availability of reports at the time of review, as 63.5% of respondents noted that radiology reports were only sometimes available when interpreting the radiographs.…”

Section: Discussionmentioning

confidence: 70%

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Are orthopaedic surgeons reading radiology reports? A Trans‐Tasman Survey

Krüger¹,

Lynskey²,

Sutherland³

2019

J Med Imag Rad Onc

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Introduction The attitudes of orthopaedic surgeons regarding radiology reporting is not well‐described in the literature. We surveyed Orthopaedic Surgeons in Australia and New Zealand to assess if they routinely review formal radiology reports. Methods An anonymized, 14 question online survey was distributed to consultant surgeons of the Australian and New Zealand Orthopaedic Associations (AOA, NZOA). Results Two hundred respondents completed the survey (Total number of Fellows: 283 NZOA, 1185 AOA). 18.5% of respondents always reviewed the formal Radiology report, 44.5% most of the time, 35% sometimes and 2% never. By imaging modality, MRI reports were the most frequently reviewed (92%), followed by ultrasound (74%) and nuclear medicine (63%). Only 10% of surgeons consulted formal reports for plain radiography. 55% of surgeons were still likely to disagree with the MRI report, followed by 46% for plain radiography. In cases of disagreement, only 21% of surgeons would always contact the reporting radiologist. The majority of Surgeons (85.5%) think there should be more collaboration between the disciplines, although only 50.5% had regular attendance of a Radiologist at their departmental audit. Conclusions This survey reveals that the majority of orthopaedic surgeons are not routinely reading radiology reports. This points towards a need for further interdisciplinary collaboration. To our knowledge, this is the first survey directly assessing attitudes of orthopaedic surgeons towards radiology reports.

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Section: Discussionmentioning

confidence: 70%

“…A retrospective analysis in the UK found that orthopaedic and radiology trainees had similar accuracy detecting suspected hip fractures . More recently, a retrospective review found that only 1% of radiology reports added new, clinically useful information in a paediatric orthopaedic clinic …”

Section: Discussionmentioning

confidence: 99%

Are orthopaedic surgeons reading radiology reports? A Trans‐Tasman Survey

Krüger¹,

Lynskey²,

Sutherland³

2019

J Med Imag Rad Onc

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“…It has been suggested that this dual interpretation does not provide value to clinical management, and eliminating radiologic interpretation would have few clinical consequences. [26][27][28] Our program reviews all hip surveillance radiology reports, and no report identified an unrelated concern, such as a malignancy. The hip surveillance team identified a density in the pelvis of an 8-year girl that was not reported by the radiologist.…”

Section: Discussionmentioning

confidence: 99%

“…25 Similarly, having both radiologists and surgeons report on radiographs of children seen in orthopaedic clinics, such as fracture clinics, may be redundant. Natarajan et al 26 found that radiologist interpretations only added new and clinically relevant information 1% of the time in a pediatric orthopaedic clinic. Du et al 27 found that radiologists and orthopaedic surgeons only disagreed on radiograph interpretation of supracondylar humerus fractures 2.4% of the time, and in no cases did radiologist opinions influence the orthopaedic management of the injury.…”

Section: Discussionmentioning

confidence: 99%

“…Du et al27 found that radiologists and orthopaedic surgeons only disagreed on radiograph interpretation of supracondylar humerus fractures 2.4% of the time, and in no cases did radiologist opinions influence the orthopaedic management of the injury. It has been suggested that this dual interpretation does not provide value to clinical management, and eliminating radiologic interpretation would have few clinical consequences 26–28. Our program reviews all hip surveillance radiology reports, and no report identified an unrelated concern, such as a malignancy.…”

Section: Discussionmentioning

confidence: 99%

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A Review of Radiology Reports From Hip Surveillance Radiographs for Children With Cerebral Palsy

Miller

Coates

Bone

et al. 2022

Journal of Pediatric Orthopaedics

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Background: Measurement of migration percentage (MP) is fundamental to successful hip surveillance for children with cerebral palsy (CP). In British Columbia, Canada, children enrolled in the province’s hip surveillance program get radiographs at the province’s tertiary care pediatric hospital or their local community hospital. This study aimed to review the radiology reporting of images completed as part of hip surveillance. Methods: Pelvis radiographs completed between September 2015 and December 2019 of 960 children enrolled in the province’s hip surveillance program were included. MP values measured by the program coordinator and corresponding value measured by the facility’s radiologist, when present, were retrieved. Agreement in MP between the program coordinator and the radiologist was measured using Bland-Altman plots and intraclass correlation coefficients. Radiology reports for images completed at community facilities that prompted a referral to a pediatric orthopaedic surgeon, when reviewed by the hip surveillance team, were further reviewed for qualitative comments. Results: In total, 1849 radiographs were reviewed with 69.3% (1282) completed at the pediatric hospital and 30.7% (567) at 64 different hospitals or clinics. MP was reported for 20.6% (264/1282) of radiographs completed at the pediatric hospital and 3.0% (17/567) of the radiographs completed at community hospitals. Bland-Altman plot analyses found a MP mean difference of 1.2% (95% confidence interval=0.6%-1.8%) between the program coordinator and all radiologist reports with an intraclass correlation coefficient of 0.88 (95% confidence interval=0.86-0.90). There were 47 radiographs completed at community hospitals that resulted in a referral to a pediatric orthopaedic surgeon after review by the hip surveillance team. Eleven of these reports stated normal or unremarkable findings. Conclusions: Radiologic reporting of images completed for hip surveillance for children with CP was inadequate to allow for the detection of hip displacement. Reporting of MP was rare, particularly in community hospitals. If radiology reporting will be utilized for hip surveillance in children with CP, education of radiologists is required.

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Added value of double reading in diagnostic radiology,a systematic review

Geijer

2018

Insights Imaging

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ObjectivesDouble reading in diagnostic radiology can find discrepancies in the original report, but a systematic program of double reading is resource consuming. There are conflicting opinions on the value of double reading. The purpose of the current study was to perform a systematic review on the value of double reading.MethodsA systematic review was performed to find studies calculating the rate of misses and overcalls with the aim of establishing the added value of double reading by human observers.ResultsThe literature search resulted in 1610 hits. After abstract and full-text reading, 46 articles were selected for analysis. The rate of discrepancy varied from 0.4 to 22% depending on study setting. Double reading by a sub-specialist, in general, led to high rates of changed reports.ConclusionsThe systematic review found rather low discrepancy rates. The benefit of double reading must be balanced by the considerable number of working hours a systematic double-reading scheme requires. A more profitable scheme might be to use systematic double reading for selected, high-risk examination types. A second conclusion is that there seems to be a value of sub-specialisation for increased report quality. A consequent implementation of this would have far-reaching organisational effects.Key Points • In double reading, two or more radiologists read the same images. • A systematic literature review was performed. • The discrepancy rates varied from 0.4 to 22% in various studies. • Double reading by sub-specialists found high discrepancy rates. Electronic supplementary materialThe online version of this article (10.1007/s13244-018-0599-0) contains supplementary material, which is available to authorised users.

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Is There Value in Having Radiology Provide a Second Reading in Pediatric Orthopaedic Clinic?

Abstract: Level III-This is a diagnostic retrospective cohort study.

Cited by 7 publications

References 7 publications

Are orthopaedic surgeons reading radiology reports? A Trans‐Tasman Survey

Are orthopaedic surgeons reading radiology reports? A Trans‐Tasman Survey

A Review of Radiology Reports From Hip Surveillance Radiographs for Children With Cerebral Palsy

Added value of double reading in diagnostic radiology,a systematic review

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