Patient recalls associated with resident-to-attending radiology report discrepancies: predictive factors for risky discrepancies

Abstract

Background: This study aimed to identify predictive factors for risky discrepancies in the emergency department (ED) by analyzing patient recalls associated with resident-to-attending radiology report discrepancies (RRDs).

Results: This retrospective study analyzed 759 RRDs in computed tomography (CT) and magnetic resonance imaging and their outcomes from 2013 to 2021. After excluding 73 patients lost to follow-up, we included 686 records in the final analysis. Risky discrepancies were defined as RRDs resulting in (1) inpatient management (hospitalization) and (2) adverse outcomes (delayed operations, 30-day in-hospital mortality, or intensive care unit admission). Predictors of risky discrepancies were assessed using multivariable logistic regression analysis. The overall RRD rate was 0.4% (759 of 171,419). Of 686 eligible patients, 21.4% (147 of 686) received inpatient management, and 6.0% (41 of 686) experienced adverse outcomes. RRDs with neurological diseases were associated with the highest ED revisit rate (79.4%, 81 of 102) but not with risky RRDs. Predictive factors of inpatient management were critical finding (odds ratio [OR], 5.60; p < 0.001), CT examination (OR, 3.93; p = 0.01), digestive diseases (OR, 2.54; p < 0.001), and late finalized report (OR, 1.65; p = 0.02). Digestive diseases (OR, 6.14; p = 0.006) were identified as the only significant predictor of adverse outcomes.

Conclusions: Risky RRDs were associated with several factors, including CT examination, digestive diseases, and late finalized reports, as well as critical image findings. This knowledge could aid in determining the priority of discrepancies for the appropriate management of RRDs.