Imaging interpretations differ between referring, specialty docs

There are substantial difference between imaging interpretations of radiologists at referring institutions and those of subspecialty radiologists at pediatric hospitals, a study has found.

According to an article in the October issue of the American Journal of Roentgenology, the study showednot only major discrepancies between original and second interpretations, but also that the second interpretations by the subspecialists were more accurate.

In the study, led by Christopher Eakins, M.D., of the department of internal medicine at Gunderson Lutheran Medical Center in La Crosse, Wis., researchers examined diagnostic imaging reports of pediatric patients admitted to a tertiary care freestanding children's hospital over a 17-month period in 2009 and 2010.  Of the 773 reports examined, "major" disagreements were found in 168 (22 percent)  and "minor" disagreements in 155 (20 percent).

Neurological studies (427) were most frequently requested for reinterpretation. In those studies major disagreements were found in 12.6 percent of cases, and minor disagreements in 21.3 percent of the cases. In 305 body imaging cases, major and minor disagreement rates were 32.6 percent and 18.7 percent respectively.

In a review of the final diagnosis in a cohort of 96 patients, second interpretations were more accurate than original interpretations in 90.2 percent of the cases (84.4 percent of the neurologic cases and 95.7 percent of the body cases).

"These findings lend support to the premise that third-party payers should recognize the need for interpretation expertise by specialty or tertiary care radiologists at the point-of-care pediatric institution to which the child has been transferred and where these findings will contribute and extensively influence the management and treatment decisions for the patient," the authors wrote.

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