The Accuracy of On-Call CT Reporting in Teleradiology Networks in Comparison to In-House Reporting

Abstract

(1) Background: We aimed to compare the accuracy of after-hours CT reports created in a traditional in-house setting versus a teleradiology setting by assessing the discrepancy rates between preliminary and final reports. (2) Methods: We conducted a prospective study to determine the number and severity of discrepancies between preliminary and final reports for 7761 consecutive after-hours CT scans collected over a 21-month period. CT exams were performed during on-call hours and were proofread by an attending the next day. Discrepancies between preliminary and gold-standard reports were evaluated by two senior attending radiologists, and differences in rates were assessed for statistical significance. (3) Results: A total of 7209 reports were included in the analysis. Discrepancies occurred in 1215/7209 cases (17%). Among these, 433/7209 reports (6%) showed clinically important differences between the preliminary and final reports. A total of 335/5509 of them were in-house reports (6.1%), and 98/1700 were teleradiology reports (5.8%). The relative frequencies of report changes were not significantly higher in teleradiology. (4) Conclusions: The accuracy of teleradiology reports was not inferior to that of in-house reports, with very similar clinically important differences rates found in both reporting situations.

Keywords: diagnostic error; quality control; reporting; resident; telemedicine.

Figure 1

Flowchart of study. During the study period, 7761 consecutive after-hours CT scans were performed. After applying the exclusion criteria, a total of 7209 reports were included in the study.

Figure 2

Relative frequencies of no differences, clinically unimportant differences, and clinically important differences for the teleradiology (black bars) versus in-house setting (grey bars). The relative frequencies of reports to which no changes were made; clinically unimportant and clinically important differences did not differ significantly between the teleradiology and the in-house setting (X²(2) = 1.828, p = 0.401, n = 7209). Found in 5.8% vs. 6.1% of cases, respectively, clinically important differences to CT reports were similarly rare in both teleradiology reporting and in-house.

Figure 3

Proportion of examined body regions in the total number of examinations for both settings. A total of 83.8% (teleradiology) and 78.4% (in-house) of all examinations consisted of a cranial CT, a head and neck CT or an abdominal CT. The portions were comparable in both study arms.