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Double Reading of Outsourced CT/MR Radiology Reports

Retrospective Analysis

Vendrell, Jean-François MD, PhD*; Frandon, Julien MD*; Boussat, Bastien MD, PhD; Cotton, François MD, PhD; Ferretti, Gilbert MD, PhD§; Sans, Nicolas MD, PhD; Tasu, Jean-Pierre MD, PhD; Beregi, Jean-Paul MD, PhD*; Larbi, Ahmed MD*

doi: 10.1097/PTS.0000000000000525
Original Article: PDF Only

Objectives Our objective was to determine disagreement rates in radiological reports provided by using a double-reading protocol in a national teleradiology company.

Methods From January 2015 to July 2016, 134169 radiological exams from 36 French centers, benefited outsourced interpretations by certified radiologists, in both regular and after-hours activities. Of these, 2040 CT and MR-scans (1.5%) were subjected to a second opinion by other radiologists in the field of their anatomical specialty (cerebral, thoracic, abdominal-pelvic, and osteoarticular). A five-point agreement scale graded from 0 to 4 was assigned for each exam. Disagreements were considered as minor if no clinical consequence for patient (scores 1 and 2) and major if potential clinical consequence (score 3 and 4). Independent radiologists performed a retrospective analysis and a stratified statistical analysis.

Results Double reading was performed on CT-scans (n = 934/2040, 45.8%) and MR-scans (n = 1106/2040, 54.2%) performed in regular (80.1%) and after-hours activities (19.9%). Disagreement scores occurred in 437 exams (21.4%), including major disagreements in 59 (2.9%). Among these, 48/754 were assigned by the thoracic second reader (6.4%), 6/70 by the abdominal-pelvic second reader (8.6%), 3/901 by the osteoarticular second reader (0.3%), and 2/315 by the cerebral second reader (0.6%), with statistical significant difference. No additional disagreement rate was observed in regular and after-hours activities (P = 0.63).

Conclusions Double-reading of outsourced CT and MRI interpretations yielded 21.4% disagreement rate, with potential clinical consequence for patient in 2,9% of the cases. These results are in accordance with those previously reported and suggests that quality assurance of outsourced interpretations is needed.

*From the department of Radiology, Nîmes University Hospital, Nîmes, France;

Quality of care unit, Grenoble Alpes University Hospital, TIMC UMR 5525 CNRS, Grenoble Alpes University, France;

Department of Radiology, Université de Lyon 1, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite Cedex, CREATIS INSA – 502, 69621 Villeurbanne Cedex, France;

§Department of Medical Informatics, Centre Hospitalier et Universitaire de Grenoble, Hôpital Nord, Boulevard de la Chantourne, 38700 La Tronche, France;

Department of Radiology, Centre Hospitalier et Universitaire de Toulouse, Hôpital Pierre-Paul Riquet, Place du Docteur Baylac - TSA 40031, 31059 Toulouse cedex 9; and

Department of radiology, Centre Hospitalier et Universitaire de Poitiers, Hôpital de la Milétrie, 2 Rue de la Milétrie, 86021 Poitiers cedex, France.

Correspondence: Jean-François Vendrell, MD, PhD, Centre Hospitalier et Universitaire de Nîmes, Hôpital Carémeau, Place du Professeur Robert Debré, 30029 Nîmes, France (e-mail:

Funding: No funding source.

Competing Interests: Drs. Vendrell Jean-François, Frandon Julien, Cotton François, Ferretti Gilbert, Sans Nicolas, and Tasu Jean-Pierre are shareholders in TeleDiag.

Ethics approval: local ethics committee, University Hospital Center of Nîmes, France.

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