Determining the clinical significance of errors in pediatric radiograph interpretation between emergency physicians and radiologists

Abstract

There is a low rate of discrepancy in the interpretation of pediatric emergency radiographs between emergency department physicians and radiologists. The majority of errors occur with radiographs of the chest and upper extremities. The low rate of clinically significant discrepancy allows safe management based on EP interpretation.

Building Emergency Medicine Trainee Competency in Pediatric Musculoskeletal Radiograph Interpretation: A Multicenter Prospective Cohort Study

“…Unfortunately, the interpretation of pediatric MSK radiographs has been shown to be relatively deficient among graduating pediatric and emergency medicine residents who will be working in EDs . These training results echo what has been noted in clinical practice, where misinterpretation of pediatric MSK radiographs in general and pediatric EDs has been estimated to be up to 19%, ,9–11 and pediatric extremity radiographs have been found to be one of the most common causes of discrepant radiograph reports . As many as 86% of these misinterpretations require a change in management, and in the United States, misdiagnoses of pediatric fractures has accounted for the third largest amount of dollars paid out to settle malpractice claims .…”

“…[4][5][6][7][8] These training results echo what has been noted in clinical practice, where misinterpretation of pediatric MSK radiographs in general and pediatric EDs has been estimated to be up to 19%, 1,[9][10][11] and pediatric extremity radiographs have been found to be one of the most common causes of discrepant radiograph reports. 12,13 As many as 86% of these misinterpretations require a change in management, 14 and in the United States, misdiagnoses of pediatric fractures has accounted for the third largest amount of dollars paid out to settle malpractice claims. 15 Research in this area has called for effective education solutions to reduce radiograph interpretation errors at the bedside.…”

Image interpretation: Learning analytics–informed education opportunities

“…4,5,7,8 Since there is a variable presentation of pneumonia on pCXR, diagnostic errors are particularly common for this subset of pCXR. 4,9,10 Unfortunately, interpretation skill does not necessarily improve with an increase in years of bedside practice as a frontline physician. 11 These diagnostic challenges may lead to missed pathology, an overprescribing of antibiotics, and litigation from patient harm related to these errors.…”

“…12,13 Considering that there are millions of pCXR done in children worldwide, the burden of these errors can be substantial. 14 To date, data on image interpretation diagnostic errors comes from expert opinion of observed errors in the clinical arena, 4,9,10 and this may provide an incomplete or biased view of sources of diagnostic challenges. This presents the potential for improvement with learner-level analytic data.…”

The Determination of Knowledge, Attitudes and Behaviors of Primary Health Care Assistants About The Evaluation of Chest X-ray: A Cross-Sectional Study

“…[5][6][7][8] PAG ve diğer grafileri değerlendirmede, radyologların diğer branş hekimlerine kıyasla anlamlı derecede daha başarılı oldukları bildirilmiştir. 9 Literatürde birinci basamak sağlık merkezlerinde çalışan hekimler ile radyologlar arası röntgen filmlerinin değerlendirilmesindeki yorum farkı %22,20 olarak belirtilmiştir. 1 PAG'ın doğru bir şekilde değerlendirilmesi, özellikle hastaların ilk başvuru noktası olan ve sık karşılaşılan solunum sistemi hastalıklarına yönelik yaklaşımda önemli bir yere sahip olan birinci basamak hekimleri için son derece önemlidir.…”