Radiology trainees can cut rates of radiology-report addenda, adding value to patient care

Radiology trainees giving second reads to experienced radiologists’ image-interpretation reports can significantly reduce the use of post-script corrections, amplifications or clarifications—i.e., addenda.

So found researchers who reviewed 129,033 reports generated over a six-month period at a pediatric tertiary-care hospital.

They found attending rads’ reports generated without second looks from residents or fellows were 12 times more likely than reports with trainee involvement to have addenda.

When present, they note, addenda may suggest under-reading of, suboptimal communications around—or errors in—initial reports.

The team reports their findings in a study published online Aug. 4 in the American Journal of Roentgenology.

Patricia Balthazar, MD, of Emory University and colleagues found 418 reports (0.3 percent) had addenda.

Advanced imaging studies were, unsurprisingly, more likely than nonadvanced studies to be associated with addendum use, while reports generated for patients in emergency or outpatient settings had a slightly higher likelihood of addendum use than those in an inpatient setting, the authors report.

Additionally, routine orders had a slightly higher likelihood of addendum use compared with immediate orders, and the researchers found no difference in addendum use by radiologist’s sex or years of experience.

“Our results suggest that trainees as second readers may provide added value” for care quality and patient safety “by decreasing addenda in radiology reports,” Balthazar and colleagues write in their discussion.

Calling for additional studies to flesh out specific explanations for their findings, the authors speculate the value-add of trainee second-reads may owe to improved proofreading of reports before signing, increased use of structured templates, increased survey of the relevant electronic medical record before report generation and/or a second set of eyes reviewing the images.

“The benefit of a second reader to prevent errors in radiology reports has been seen in multiple settings and modalities, but it has been most studied in screening mammography,” they write. “Although double reading by attending radiologists has been shown to be cost-effective for screening mammograms, trainees as second readers might be an alternative protective factor for errors in more costly studies for which adding a second attending radiologist might not be cost-effective.”