RADPEER Peer Review: Relevance, Use, Concerns, Challenges, and Direction Forward

Abujudeh, Hani H.; Pyatt, Robert S.; Bruno, Michael A.; Chetlen, Alison L.; Buck, David; Hobbs, Susan K.; Roth, Christopher J.; Truwit, Charles L.; Agarwal, Rajan; Kennedy, Scott; Glenn, Lucille

doi:10.1016/j.jacr.2014.02.004

Cited by 57 publications

(24 citation statements)

References 5 publications

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“…On the other hand, the positive effect of receiving a discrepant report on submitting discrepant reports may illustrate a positive bias rather than a negative reaction. While previous studies have shown that radiologists tend to underreport discrepancies on peer review, 12,13 in contrast, our data suggest that receiving a discrepant report may motivate the radiologist to review their colleagues' reports more diligently and potentially identify errors that might otherwise be overlooked. However according to our findings, participants tend to submit more discrepancy reports on their colleagues when they receive a not clinically significant report compared with a clinically significant one.…”

Section: Discussioncontrasting

confidence: 76%

“…One-third of respondents admitted that there was underreporting of disagreements in the peer review process at their practice. 12 This underreporting highlights the current peer review systems deficits. Peer review may elicit anxiety, shame, humiliation, and fear, leading to a reluctance to report disagreements.…”

Section: Discussionmentioning

confidence: 98%

“…In an American College of Radiology survey assessing the RADPEER program, most radiologists opined that the peer review system is only performed to meet accreditation and hospital credentialing requirements. 12 Nearly half believed that their practice patterns had not changed as a result of peer review. One-third of respondents admitted that there was underreporting of disagreements in the peer review process at their practice.…”

Section: Discussionmentioning

confidence: 99%

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Bias in Neuroradiology Peer Review: Impact of a “Ding” on “Dinging” Others

Charkhchi

Wang

Caffo

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: The validity of radiology peer review requires an unbiased assessment of studies in an environment that values the process. We assessed radiologists' behavior reviewing colleagues' reports. We hypothesized that when a radiologist receives a discrepant peer review, he is more likely to submit a discrepant review about another radiologist. MATERIALS AND METHODS: We analyzed the anonymous peer review submissions of 13 neuroradiologists in semimonthly blocks of time from 2016 to 2018. We defined a discrepant review as any one of the following: 1) detection miss, clinically significant; 2) detection miss, clinically not significant; 3) interpretation miss, clinically significant; or 4) interpretation miss, clinically not significant. We used randomeffects Poisson regression analysis to determine whether a neuroradiologist was more likely to submit a discrepant report during the semimonthly block in which he or she received one versus the semimonthly block thereafter. RESULTS: Four hundred sixty-eight discrepant peer review reports were submitted; 161 were submitted in the same semimonthly block of receipt of a discrepant report and 325 were not. Receiving a discrepant report had a positive effect on submitting discrepant reports: an expected relative increase of 14% (95% CI, 8%-21%). Notably, receiving a clinically not significant discrepant report (coefficient ϭ 0.13; 95% CI, 0.05-0.22) significantly and positively correlated with submitting a discrepant report within the same time block, but this was not true of clinically significant reports. CONCLUSIONS: The receipt of a clinically not significant discrepant report leads to a greater likelihood of submitting a discrepant report. The motivation for such an increase should be explored for potential bias.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Bias in Neuroradiology Peer Review: Impact of a “Ding” on “Dinging” Others

Charkhchi

Wang

Caffo

et al. 2018

AJNR Am J Neuroradiol

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“…To meet The Joint Commission requirements for OPPE, departments must maintain data on at least six practitioner-specific parameters in the six specified categories. Although at least one author has pointed out that Radpeer was not intended to be used for OPPE (12), others have advocated the use of practitioner data to meet OPPE requirements as one of the benefits of the Radpeer approach (11,16,17). In addition to OPPE, The Joint Commission also requires a complementary program, focused professional practice evaluation (FPPE), to be invoked when a provider's performance comes into question (18,19).…”

mentioning

confidence: 99%

Peer Feedback, Learning, and Improvement: Answering the Call of the Institute of Medicine Report on Diagnostic Error

et al. 2017

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In September 2015, the Institute of Medicine (IOM) published a report titled "Improving Diagnosis in Health Care," in which it was recommended that "health care organizations should adopt policies and practices that promote a nonpunitive culture that values open discussion and feedback on diagnostic performance." It may seem counterintuitive that a report addressing a highly technical skill such as medical diagnosis would be focused on organizational culture. The wisdom becomes clearer, however, when examined in the light of recent advances in the understanding of human error and individual and organizational performance. The current dominant model for radiologist performance improvement is scoring-based peer review, which reflects a traditional quality assurance approach, derived from manufacturing in the mid-1900s. Far from achieving the goals of the IOM, which are celebrating success, recognizing mistakes as an opportunity to learn, and fostering openness and trust, we have found that scoring-based peer review tends to drive radiologists inward, against each other, and against practice leaders. Modern approaches to quality improvement focus on using and enhancing interpersonal professional relationships to achieve and maintain high levels of individual and organizational performance. In this article, the authors review the recommendations set forth by the recent IOM report, discuss the science and theory that underlie several of those recommendations, and assess how well they fit with the current dominant approach to radiology peer review. The authors also offer an alternative approach to peer review: peer feedback, learning, and improvement (or more succinctly, "peer learning"), which they believe is better aligned with the principles promoted by the IOM. RSNA, 2016.

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“…However, voluntary reporting is subject to subjective interpretation, underreporting, and reporting bias (12)(13)(14). In a 2012 ACR survey of PR, 33% of respondents believed that there was underreporting of significant disagreement in the PR process in their practices (15). Therefore, it is important to identify an optimal format for error detection, review, and prevention (16).…”

mentioning

confidence: 99%