Jared T Verdoorn, Christopher H Hunt, Marianne T Luetmer, Christopher P Wood, Laurence J Eckel, Kara M Schwartz, Felix E Diehn, David F Kallmes
{"title":"增加随叫随到的神经放射学检查量并不会导致住院医师进行的初级读数的主要差异增加。","authors":"Jared T Verdoorn, Christopher H Hunt, Marianne T Luetmer, Christopher P Wood, Laurence J Eckel, Kara M Schwartz, Felix E Diehn, David F Kallmes","doi":"10.2174/1874440001408010011","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>A common perception is that increased on-call workload leads to increased resident mistakes. To test this, we evaluated whether increased imaging volume has led to increased errors by residents.</p><p><strong>Materials and methods: </strong>A retrospective review was made of all overnight neuroradiology CT exams with a primary resident read from 2006-2010. All studies were over-read by staff neuroradiologists next morning. As the volume is higher on Friday through Sunday nights, weekend studies were examined separately. Discrepancies were classified as either minor or major. \"Major\" discrepancy was defined as a discrepancy that the staff radiologist felt was significant enough to potentially affect patient care, necessitating a corrected report and phone contact with the ordering physician and documentation. The total number of major discrepancies was recorded by quarter. In addition, the total number of neuroradiology CT studies read overnight on-call was noted.</p><p><strong>Results: </strong>The mean number of cases per night during the weekday increased from 3.0 in 2006 to 5.2 in 2010 (p<0.001). During the weekend, the mean number of cases per night increased from 5.4 in 2006 to 7.6 in 2010 (p<0.001). Despite this increase, the major discrepancy rate decreased from 2.7% in 2006 to 2.3% in 2010 (p=0.34).</p><p><strong>Conclusion: </strong>Despite an increase in neuroradiology exam volumes, there continues to be a low major discrepancy rate for primary resident interpretations. While continued surveillance of on-call volumes is crucial to the educational environment, concern of increased major errors should not be used as sole justification to limit autonomy.</p>","PeriodicalId":37431,"journal":{"name":"Open Neuroimaging Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/a2/TONIJ-8-11.PMC4311384.pdf","citationCount":"10","resultStr":"{\"title\":\"Increasing neuroradiology exam volumes on-call do not result in increased major discrepancies in primary reads performed by residents.\",\"authors\":\"Jared T Verdoorn, Christopher H Hunt, Marianne T Luetmer, Christopher P Wood, Laurence J Eckel, Kara M Schwartz, Felix E Diehn, David F Kallmes\",\"doi\":\"10.2174/1874440001408010011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>A common perception is that increased on-call workload leads to increased resident mistakes. To test this, we evaluated whether increased imaging volume has led to increased errors by residents.</p><p><strong>Materials and methods: </strong>A retrospective review was made of all overnight neuroradiology CT exams with a primary resident read from 2006-2010. All studies were over-read by staff neuroradiologists next morning. As the volume is higher on Friday through Sunday nights, weekend studies were examined separately. Discrepancies were classified as either minor or major. \\\"Major\\\" discrepancy was defined as a discrepancy that the staff radiologist felt was significant enough to potentially affect patient care, necessitating a corrected report and phone contact with the ordering physician and documentation. The total number of major discrepancies was recorded by quarter. In addition, the total number of neuroradiology CT studies read overnight on-call was noted.</p><p><strong>Results: </strong>The mean number of cases per night during the weekday increased from 3.0 in 2006 to 5.2 in 2010 (p<0.001). During the weekend, the mean number of cases per night increased from 5.4 in 2006 to 7.6 in 2010 (p<0.001). Despite this increase, the major discrepancy rate decreased from 2.7% in 2006 to 2.3% in 2010 (p=0.34).</p><p><strong>Conclusion: </strong>Despite an increase in neuroradiology exam volumes, there continues to be a low major discrepancy rate for primary resident interpretations. While continued surveillance of on-call volumes is crucial to the educational environment, concern of increased major errors should not be used as sole justification to limit autonomy.</p>\",\"PeriodicalId\":37431,\"journal\":{\"name\":\"Open Neuroimaging Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-01-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/a2/TONIJ-8-11.PMC4311384.pdf\",\"citationCount\":\"10\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Neuroimaging Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/1874440001408010011\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2014/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Neuroimaging Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1874440001408010011","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2014/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Increasing neuroradiology exam volumes on-call do not result in increased major discrepancies in primary reads performed by residents.
Background and purpose: A common perception is that increased on-call workload leads to increased resident mistakes. To test this, we evaluated whether increased imaging volume has led to increased errors by residents.
Materials and methods: A retrospective review was made of all overnight neuroradiology CT exams with a primary resident read from 2006-2010. All studies were over-read by staff neuroradiologists next morning. As the volume is higher on Friday through Sunday nights, weekend studies were examined separately. Discrepancies were classified as either minor or major. "Major" discrepancy was defined as a discrepancy that the staff radiologist felt was significant enough to potentially affect patient care, necessitating a corrected report and phone contact with the ordering physician and documentation. The total number of major discrepancies was recorded by quarter. In addition, the total number of neuroradiology CT studies read overnight on-call was noted.
Results: The mean number of cases per night during the weekday increased from 3.0 in 2006 to 5.2 in 2010 (p<0.001). During the weekend, the mean number of cases per night increased from 5.4 in 2006 to 7.6 in 2010 (p<0.001). Despite this increase, the major discrepancy rate decreased from 2.7% in 2006 to 2.3% in 2010 (p=0.34).
Conclusion: Despite an increase in neuroradiology exam volumes, there continues to be a low major discrepancy rate for primary resident interpretations. While continued surveillance of on-call volumes is crucial to the educational environment, concern of increased major errors should not be used as sole justification to limit autonomy.
期刊介绍:
The Open Neuroimaging Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, and letters in all important areas of brain function, structure and organization including neuroimaging, neuroradiology, analysis methods, functional MRI acquisition and physics, brain mapping, macroscopic level of brain organization, computational modeling and analysis, structure-function and brain-behavior relationships, anatomy and physiology, psychiatric diseases and disorders of the nervous system, use of imaging to the understanding of brain pathology and brain abnormalities, cognition and aging, social neuroscience, sensorimotor processing, communication and learning.