Abstract
Background
Extremity pain represents one of the most common reasons for obtaining conventional radiographs in childhood. Despite the frequency of these examinations little is known about the incidence of diagnostic errors by interpreting pediatric radiologists.
Objective
The purpose of this study was to develop a standard error rate of pediatric radiologists by double-reading of extremity radiographs (elbow, wrists, knees and ankles) in children presenting with a history of trauma or pain.
Materials and methods
During a 6-month period all major extremity radiographs (excluding digits) obtained at a large pediatric referral hospital for evaluation of pain or trauma were reviewed by two senior pediatric radiologists and compared to the official interpretation. All radiographs were interpreted initially by a board-certified pediatric radiologist with a Certificate of Added Qualification (CAQ). We reviewed 3,865 radiographic series in children and young adults 2–20 years of age. We tabulated misses and overcalls. We did not assess the clinical significance of the errors.
Results
There were 61 miss errors and 44 overcalls in 1,235 abnormal cases and 2,630 normal cases, for a 1.6% miss rate and a 1.1% overcall rate. Misses and overcalls were most common in the ankle.
Conclusion
Interpretive errors by pediatric radiologists reviewing certain musculoskeletal radiographs are relatively infrequent. Diagnostic errors in the form of a miss or overcall occurred in 2.7% of the radiographs.
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References
Borgstede JP, Lewis RS, Bhargavan M et al (2004) RADPEER quality assurance program: a multifacility study of interpretive disagreement rates. J Am Coll Radiol 1:59–65
Garland LH (1949) On the scientific evaluation of diagnostic procedures. Radiology 52:309–328
Berlin L (2007) Accuracy of diagnostic procedures: has it improved over the past 5 decades? AJR Am J Roentgenol 188:1173–1178
Siegle RL, Baram EM, Reuter SR et al (1998) Rates of disagreement in imaging interpretation in a group of community hospitals. Acad Radiol 5:148–154
Soffa DJ, Lewis RS, Sunshine JH et al (2004) Disagreement in interpretation: a method for the development of benchmarks for quality assurance in imaging. J Am Coll Radiol 1:212–217
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Bisset, G.S., Crowe, J. Diagnostic errors in interpretation of pediatric musculoskeletal radiographs at common injury sites. Pediatr Radiol 44, 552–557 (2014). https://doi.org/10.1007/s00247-013-2869-9
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DOI: https://doi.org/10.1007/s00247-013-2869-9