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Objective <p>To evaluate discrepancy rates between provisional radiology resident interpretations and final attending radiologist reports for emergency on-call imaging studies, and to assess the clinical significance and inter-reviewer variability of these discrepancies using the American College of Radiology (ACR) RadPeer scoring system.</p> Methods <p>This retrospective pilot quality-improvement study analyzed 1367 emergency imaging studies interpreted by on-call radiology residents over an 8-week period. Discrepancies were identified via a dedicated institutional quality-assurance system activated manually by the approving radiologist when a provisional report is modified to include findings that significantly alter the interpretation; once activated, an automated alert pathway communicates the change directly to the clinical referring team. Discrepancies were categorized by clinical significance (non-significant: 2a/3a; significant: 2b/3b) and stratified by modality (computed tomography [CT], magnetic resonance imaging [MRI], and ultrasound [US]) and body region (neuroimaging, chest/abdomen). Two board-certified radiologists independently assigned RadPeer 2016 scores to the discrepant cases, stratified by body region.</p> Results <p>Seventy discrepancies were identified, yielding an overall discrepancy rate of 5.1% (70/1,367). Of these, 64.3% (45/70) were classified as clinically significant (RadPeer 2b or 3b). Overall inter-reviewer agreement was 80%, with the highest variability observed in neuroimaging (30% disagreement) compared to chest/abdomen (12.5% disagreement).</p> Conclusion <p>In this pilot evaluation, discrepancy rates were within reported literature ranges. However, the high proportion of clinically significant discrepancies and the observed inter-reviewer variability highlight the importance of structured peer-review processes and targeted educational feedback.</p>

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Evaluating discrepancy rates between provisional radiology resident reports and final interpretations of emergency on-call studies: a pilot quality-improvement analysis using the RadPeer scoring system

  • 期刊论文

  • 发表日期：

    2026年7月31日

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  • Danah Krimli,
  • Salah Shihata,
  • Abdulbari Felemban,
  • Abdulmalek Alzahrani,
  • Badr Bannan,
  • Zehour Alsabban,
  • Ohoud Alaslani,
  • Marwa Aljehani,
  • Mohammad Alsayed,
  • Zergham Zia

摘要

Objective

To evaluate discrepancy rates between provisional radiology resident interpretations and final attending radiologist reports for emergency on-call imaging studies, and to assess the clinical significance and inter-reviewer variability of these discrepancies using the American College of Radiology (ACR) RadPeer scoring system.

Methods

This retrospective pilot quality-improvement study analyzed 1367 emergency imaging studies interpreted by on-call radiology residents over an 8-week period. Discrepancies were identified via a dedicated institutional quality-assurance system activated manually by the approving radiologist when a provisional report is modified to include findings that significantly alter the interpretation; once activated, an automated alert pathway communicates the change directly to the clinical referring team. Discrepancies were categorized by clinical significance (non-significant: 2a/3a; significant: 2b/3b) and stratified by modality (computed tomography [CT], magnetic resonance imaging [MRI], and ultrasound [US]) and body region (neuroimaging, chest/abdomen). Two board-certified radiologists independently assigned RadPeer 2016 scores to the discrepant cases, stratified by body region.

Results

Seventy discrepancies were identified, yielding an overall discrepancy rate of 5.1% (70/1,367). Of these, 64.3% (45/70) were classified as clinically significant (RadPeer 2b or 3b). Overall inter-reviewer agreement was 80%, with the highest variability observed in neuroimaging (30% disagreement) compared to chest/abdomen (12.5% disagreement).

Conclusion

In this pilot evaluation, discrepancy rates were within reported literature ranges. However, the high proportion of clinically significant discrepancies and the observed inter-reviewer variability highlight the importance of structured peer-review processes and targeted educational feedback.