Experts explore the relationship between interpretation time and diagnostic errors in neuroradiology

According to an accepted manuscript published in ARRS’ American Journal of Roentgenology (AJR), diagnostic errors in neuroradiology were associated with longer interpretation times, higher shift volumes, and weekend interpretation.

The researchers noted that their findings should be considered when designing workflow-related interventions that would reduce such interpretative errors.

“The identified risk factors for diagnostic error in neuroradiology could be used to guide targeted quality improvement interventions,” explained corresponding author Vladimir Ivanovic, MD, from the Medical College of Wisconsin.

QA = quality assurance

Ivanovic and his team’s retrospective case-control study reportedly used a large tertiary-care academic medical center’s neuroradiology quality assurance database to evaluate CT and MRI examinations from January 2014 through March 2020, for which neuroradiologists had assigned RADPEER scores. Database searches were performed for examinations both without (RADPEER score 1) and with (RADPEER scores 2a, 2b, 3a, 3b, or 4) diagnostic error. For each examination with error, two examinations without error were randomly selected—unless only one examination could be identified—matched by interpreting radiologist and examination type, to form case and control groups, respectively. The authors of the manuscript then used models to assess associations of diagnostic error with interpretation time (minutes since preceding report’s completion), shift volume (examinations interpreted during shift), emergency/inpatient setting, weekend interpretation, and trainee participation in interpretation.

The researchers concluded that diagnostic error of neuroradiology examinations was independently associated with longer interpretation time (OR=1.18), higher shift volume (OR=1.27), and weekend interpretation (OR=1.69). Diagnostic error was not associated with emergency/inpatient setting or trainee participations. In subanalysis, diagnostic error was associated with interpretation time and shift volume on weekdays, though not on weekends.