Trainees May Add Value to Patient Care by Decreasing Addendum Utilization in Radiology Reports

Balthazar, Patricia; Konstantopoulos, Christina; Wick, Carson A.; DeSimone, Ariadne K.; Tridandapani, Srini; Simoneaux, Stephen F.; Applegate, Kimberly E.

doi:10.2214/ajr.17.18339

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…The power of double reading in the trainee-and-attending radiologist dyad model was highlighted in a recent study by Balthazar et al (21), which showed that radiology reports generated without trainee involvement were up to 12 times more likely to include a later addendum than were reports with trainee involvement. The need for an addendum is generally indicative of the presence of one or more errors in the radiology report that were discovered only after the report was finalized by an attending radiologist.…”

Section: Cost and Cost-effectivenessmentioning

confidence: 99%

Overnight Resident versus 24-hour Attending Radiologist Coverage in Academic Medical Centers

et al. 2018

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Radiology 2018; 289:809-813 • https://doi.org/10.1148/radiol.2018180690 • Content code:Academic medical centers have long relied on radiology residents to provide after-hours coverage, which means that they essentially function with autonomy. In this approach, attending radiologist review of resident interpretations occurs the following morning, often by subspecialist faculty. In recent years, however, this traditional coverage model in academic radiology departments has been challenged by an alternative model, the 24-hour attending radiologist coverage. Proponents of this new model seek to improve patient care after hours by increasing report accuracy and the speed with which the report is finalized. In this article, we review the traditional and the 24-hour attending radiologist coverage models. We summarize previous studies that indicate that resident overnight error rates are sufficiently low so that changing to an overnight attending model may not necessarily provide a meaningful increase in report accuracy. Whereas some centers completely replaced overnight residents, we note that most centers use a hybrid model, and overnight residents work alongside supervising attending radiologists, much as they do during the day. Even in this hybrid model, universal double reading and subspecialist final review, typical features of the traditional autonomous resident coverage model, are generally sacrificed. Because of this, changing from resident coverage to coverage by an attending radiologist that is 24 hours/day, 7 days/week may actually have detrimental effects to patient safety and quality of care provided. Changing to an overnight attending radiologist model may also have negative effects on the quality of radiology resident training, and it significantly increases cost.

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Section: Cost and Cost-effectivenessmentioning

confidence: 99%

Overnight Resident versus 24-hour Attending Radiologist Coverage in Academic Medical Centers

et al. 2018

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“…Several studies in the past have used different methods and study populations to analyze radiological error rates and have obtained variable results ( Table 4 ). 1 8 9 10 11 12 13 14 15 16 This is because of the absence of a single, standard, and universally reproducible process of analyzing radiological errors.…”

Section: Discussionmentioning

confidence: 99%

“…There is limited literature that evaluates report addenda as a tool for error analysis, summarized in Table 4 . 1 8 9 10 One such noteworthy work by Brigham et al 8 used report addenda to calculate error rates in 5,568 reports and classified them based on etiology and image modality. These studies reflect an agreement that addenda analysis as a self-acknowledged method of error detection is less time consuming and minimizes the interobserver variability in image interpretation compared with the peer review method in previous works.…”

Section: Discussionmentioning

confidence: 99%

Radiology Reporting Errors: Learning from Report Addenda

Patra

Premkumar

Keshava

et al. 2021

Indian J Radiol Imaging

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Background The addition of new information to a completed radiology report in the form of an “addendum” conveys a variety of information, ranging from less significant typographical errors to serious omissions and misinterpretations. Understanding the reasons for errors and their clinical implications will lead to better clinical governance and radiology practice. Aims This article assesses the common reasons which lead to addenda generation to completed reports and their clinical implications. Subjects and Methods Retrospective study was conducted by reviewing addenda to computed tomography (CT), ultrasound, and magnetic resonance imaging reports between January 2018 to June 2018, to note the frequency and classification of report addenda. Results Rate of addenda generation was 1.1% (n = 1,076) among the 97,003 approved cross-sectional radiology reports. Errors contributed to 71.2% (n = 767) of addenda, most commonly communication (29.3%, n = 316) and observational errors (20.8%, n = 224), and 28.7% were nonerrors aimed at providing additional clinically relevant information. Majority of the addenda (82.3%, n = 886) did not have a significant clinical impact. CT and ultrasound reports accounted for 36.9% (n = 398) and 35.2% (n = 379) share, respectively. A time gap of 1 to 7 days was noted for 46.8% (n = 504) addenda and 37.6% (n = 405) were issued in less than a day. Radiologists with more than 6-year experience created majority (1.5%, n = 456) of addenda. Those which were added to reports generated during emergency hours contributed to 23.2% (n = 250) of the addenda. Conclusion The study has identified the prevalence of report addenda in a radiology practice involving picture archiving and communication system in a tertiary care center in India. The etiology included both errors and non-errors. Results of this audit were used to generate a checklist and put protocols that will help decrease serious radiology misses and common errors.

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Multivariate Analysis of Radiologists’ Usage of Phrases that Convey Diagnostic Certainty

et al. 2019

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Trainees May Add Value to Patient Care by Decreasing Addendum Utilization in Radiology Reports

Abstract: Trainees may add value to patient care by decreasing addendum rates in radiology reports.

Cited by 7 publications

References 23 publications

Overnight Resident versus 24-hour Attending Radiologist Coverage in Academic Medical Centers

Overnight Resident versus 24-hour Attending Radiologist Coverage in Academic Medical Centers

Radiology Reporting Errors: Learning from Report Addenda

Multivariate Analysis of Radiologists’ Usage of Phrases that Convey Diagnostic Certainty

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