Pediatric emergency physician interpretation of plain radiographs: Is routine review by a radiologist necessary and cost-effective?

Annals of Emergency Medicine
H K SimonJ A Wright

Abstract

To determine the concordance rate of plain radiograph interpretations by pediatric emergency physicians and pediatric radiologists, to evaluate the effect of incorrect radiologic diagnosis on patient management, and to evaluate the necessity and cost-effectiveness of routine follow-up review of all plain radiographs by a radiologist. We assembled a prospective series of all patients who presented to the emergency department of an urban tertiary care children's hospital and underwent plain radiography between October 1 and October 31, 1994. Pediatric emergency physicians documented their interpretations. Within 24 hours, films were reviewed by a pediatric radiologist. The two interpretations were classified as concordant or discordant and were further assessed for medical significance and subsequent change in management. During the study period, 707 radiographic examinations were performed: chest, 56%; skeletal excluding spine, 20.1%; abdomen, 11.9%; sinus, 4.2%; spine, 3.6%; and other, 4%. The accuracy or concordance rate was 90.2% (638 of 707) for pediatric emergency physician interpretations; clinical management was unchanged in 96.9% (685 of 707) of the cases. Of the 69 discordant interpretations, 48 were clinically signific...Continue Reading

References

Mar 1, 1983·Annals of Emergency Medicine·G FleisherM McSorley
Apr 1, 1995·Pediatric Emergency Care·C A Delgado, G R Fleisher

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Citations

Aug 21, 2002·Pediatric Emergency Care·Shabnam Jain, Kevin Sullivan
Jul 20, 2002·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·S TachakraD Dutton
May 27, 2010·Pediatric Emergency Care·Manuel D BilkisOsvaldo Bello Pedrosa
Oct 2, 2012·Pediatric Emergency Care·Michalle SoudackArie Augarten
May 14, 2003·Postgraduate Medical Journal·M E GattR Stalnikowicz
Nov 1, 2000·Critical Care : the Official Journal of the Critical Care Forum·C R ChamblissK Sullivan
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Jan 22, 2010·Emergency Radiology·Jeremiah Johnson, Jeffrey A Kline
Aug 13, 2013·Medical Education·Kathy BoutisMartin V Pusic
Nov 4, 2016·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·John ChengShabnam Jain
Jul 31, 2004·Emergency Medicine Australasia : EMA·Ian HigginsonRichard Aickin
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Jul 14, 1998·Journal of Pediatric Orthopedics·G L Zohman, H G Watts
Nov 9, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Faisal Al-SaniKathy Boutis

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