Common Resident Errors When Interpreting Computed Tomography of the Abdomen and Pelvis: A Review of Types, Pitfalls, and Strategies for Improvement

The purpose of this study was to identify common errors that radiology residents make when interpreting abdominopelvic (AP) computed tomography (CT) while on call, to review the typical imaging findings of these cases, and to discuss strategies for improvement. AP (or chest, abdomen, pelvis) CTs fro...

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Bibliographic Details
Published in:Current problems in diagnostic radiology 2019-01, Vol.48 (1), p.4-9
Main Authors: Wildman-Tobriner, Benjamin, Allen, Brian C., Maxfield, Charles M.
Format: Article
Language:English
Subjects:
Clinical Competence
Diagnostic Errors - statistics & numerical data
Humans
Internship and Residency
Quality Improvement
Radiography, Abdominal
Radiology - education
Risk Factors
Tomography, X-Ray Computed
Workload
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Summary:The purpose of this study was to identify common errors that radiology residents make when interpreting abdominopelvic (AP) computed tomography (CT) while on call, to review the typical imaging findings of these cases, and to discuss strategies for improvement. AP (or chest, abdomen, pelvis) CTs from 518 weekend senior call shifts (R3 or R4) were retrospectively reviewed. Discrepancies between preliminary and final reports were identified and then rated by whether the miss could impact short-term management. The imaging findings from the cases were reviewed. A total of 4695 CTs were reviewed, revealing a total of 145 discrepancies that could affect short-term clinical management (miss rate 3.1%). The most common misses were related to blood clots (13.8%), colitis (8.3%), misplaced lines or tubes (6.9%), or pyelonephritis (5.5%). Common pitfalls and strategies from improved detection are discussed using image examples. Through increased attention to the vasculature, colon, devices, and kidneys, trainees may improve their discrepancy rates and improve on-call reporting.
ISSN:0363-0188
1535-6302
DOI:10.1067/j.cpradiol.2017.12.010