Radiological review of accident and emergency radiographs: a 1-year audit. Export

@article{Williams:ClinRadiol:2000, abstract = {AIM: To assess the impact and cost effectiveness of a system of radiological review of accident and emergency (A\&E) plain films. MATERIALS AND METHODS: Review documentation was studied retrospectively over a 1-year period. Six hundred and eighty-four actual or suspected errors in the initial radiological interpretation by A\&E staff were highlighted by radiologists in training. These selected 'red reports' were then further reviewed by a musculoskeletal radiologist and a more senior member of the A\&E team. RESULTS: Three hundred and fifty-one missed or strongly suspected fractures were detected, with ankle, finger and elbow lesions predominating. Other errors included 11 missed chest radiograph abnormalities and 24 A\&E false-positives. Radiologists in training tended to over-report abnormalities with an 18\%false-positive rate when compared to the subsequent musculoskeletal radiology opinion. Following review, further action was taken by A\&E staff in 286 (42.6\%) of cases. No operative intervention was required in those patients with a delayed or missed A\&E diagnosis. Consideration is given to the cost of providing this form of review and the impact of medico-legal factors. CONCLUSION: Compared with the large numbers of patients seen and radiographed in a busy A\&E department, the number of radiological errors was small. There were even fewer changes in management. Despite this, concern over litigation, clinical governance and future work patterns in A\&E make this form of review a useful means of risk reduction in a teaching hospital.Williams, S. M. (2000). Clinical Radiology55, 861-865 Copyright 2000 The Royal College of Radiologists.}, author = {Williams, S. M. and Connelly, D. J. and Wadsworth, S. and Wilson, D. J.}, citeulike-article-id = {2535198}, citeulike-linkout-0 = {http://dx.doi.org/10.1053/crad.2000.0548}, doi = {10.1053/crad.2000.0548}, journal = {Clin Radiol}, keywords = {audit, diagnostic\_errors}, month = {November}, number = {11}, organization = {Department of Radiology, John Radcliffe Hospital, Headington, Oxford, UK.}, pages = {861--5}, posted-at = {2008-03-15 00:26:12}, priority = {2}, title = {Radiological review of accident and emergency radiographs: a 1-year audit.}, url = {http://dx.doi.org/10.1053/crad.2000.0548}, volume = {55}, year = {2000} }

TY - JOUR ID - Williams:ClinRadiol:2000 L3 - citeulike-article-id:2535198 N2 - AIM: To assess the impact and cost effectiveness of a system of radiological review of accident and emergency (A&E) plain films. MATERIALS AND METHODS: Review documentation was studied retrospectively over a 1-year period. Six hundred and eighty-four actual or suspected errors in the initial radiological interpretation by A&E staff were highlighted by radiologists in training. These selected 'red reports' were then further reviewed by a musculoskeletal radiologist and a more senior member of the A&E team. RESULTS: Three hundred and fifty-one missed or strongly suspected fractures were detected, with ankle, finger and elbow lesions predominating. Other errors included 11 missed chest radiograph abnormalities and 24 A&E false-positives. Radiologists in training tended to over-report abnormalities with an 18%false-positive rate when compared to the subsequent musculoskeletal radiology opinion. Following review, further action was taken by A&E staff in 286 (42.6%) of cases. No operative intervention was required in those patients with a delayed or missed A&E diagnosis. Consideration is given to the cost of providing this form of review and the impact of medico-legal factors. CONCLUSION: Compared with the large numbers of patients seen and radiographed in a busy A&E department, the number of radiological errors was small. There were even fewer changes in management. Despite this, concern over litigation, clinical governance and future work patterns in A&E make this form of review a useful means of risk reduction in a teaching hospital.Williams, S. M. (2000). Clinical Radiology55, 861-865 Copyright 2000 The Royal College of Radiologists. IS - 11 JF - Clin Radiol OR - Department of Radiology, John Radcliffe Hospital, Headington, Oxford, UK. EP - 5 TI - Radiological review of accident and emergency radiographs: a 1-year audit. VL - 55 SP - 861 KW - audit KW - diagnostic_errors AU - Williams, SM AU - Connelly, DJ AU - Wadsworth, S AU - Wilson, DJ PY - 2000/11// UR - http://dx.doi.org/10.1053/crad.2000.0548 ER -