Slow down, speed readers: Faster radiology reporting times result in more major mistakes

A significant amount of misses and major reporting mistakes occur when radiologists increase imaging reporting speeds, according to results of a study published online May 21 in the Journal of the American College of Radiology.

As the average radiologist’s workload continues to swell, so does the burden of efficiently interpreting large amounts of diagnostic images in short amount of time. But that emphasis on quantity can have an adverse effect on the quality of radiological reporting, according to lead author Evgeniya Sokolovskaya, DO, MD, and her colleagues at Monmouth Medical Center in Long Branch, N.J. “Radiologists are under pressure to increase productivity by increasing workload volume,” wrote Sokolovskaya and colleagues. “Studies have shown that a decrease occurs in both the accuracy of radiologic interpretation and the detection of pathology as the volume of interpreted studies increases and the viewing time per study decreases.”

Sokolovskaya and her colleagues set out to determine how faster reporting speeds affected radiologists reading abdomen-pelvis CT imaging studies, and whether this increased reading-speed would result in more misses and interpretation errors. To do so, they tested five attending radiologists with randomly assigned sets of 12 imaging abdomen-pelvis CT scans of varying complexity from a pool of 53 such imaging studies performed at a teaching hospital during the duration of the study. An average baseline reporting time was established for each radiologist using one sample set. Once the baseline was established, the researchers gave the radiologists another set of images with a similar difficulty and asked them to interpret at twice their normal speed, then analyzed major and minor misses and mistakes.

Their results showed that four of the five radiologists had more misses and mistakes when reading at the faster speed. Overall, the total number of major misses during the increased speed reading time was 16 of 60 cases versus six of 60 reported cases at normal speed. The five radiologists’ average interpretation error rate of major misses for the faster speed was 27 percent, compared with just 10 percent at their normal speeds.

“Our study found a significant positive correlation between faster reading speed and the number of major misses and interpretation errors in radiologists’ reading of abdomen-pelvis CT scans,” wrote Sokolovskaya and colleagues. “The findings of our study suggest that the speed of radiology interpretations may have a strong impact on the quality of patient care.”

The changing landscape of radiology, as well as financial considerations could increase pressure on radiologists to read imaging studies more quickly, according to the authors, who also believe more research is necessary to determine the effects on patient safety. “Many radiologists are being employed by teleradiology firms, hospitals, and private groups, where their reimbursement is directly based on the number of cases they read. This situation provides strong financial motivation for radiologists to read cases as quickly as they can,” the researchers wrote. “A larger, multicenter study with many cases interpreted by the radiologists, and case selection similar to the average workload, would be helpful to confirm our findings and better elucidate the implications for patients’ safety of reporting at a faster rate for prolonged periods.”