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Rofo 2021; 193(02): 160-167
DOI: 10.1055/a-1178-1113
Health Policy and Evidence Based Medicine

Time Requirement and Feasibility of a Systematic Quality Peer Review of Reporting in Radiology

Zeitaufwand und Machbarkeit einer systematischen Qualitätsbeurteilung radiologischer Befunde
Martin H. Maurer
1   Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern Universtity Hospital, University of Bern, Switzerland
,
Michael Brönnimann
1   Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern Universtity Hospital, University of Bern, Switzerland
,
Christophe Schroeder
1   Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern Universtity Hospital, University of Bern, Switzerland
,
Ehssan Ghadamgahi
2   Radiology, CT-MRT Institute, Berlin, Germany
,
Florian Streitparth
3   Department of Radiology, LMU University Hospital, Munich, Germany
,
Johannes T. Heverhagen
1   Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern Universtity Hospital, University of Bern, Switzerland
,
Alexander Leichtle
4   Institute of Clinical Chemistry, Inselspital, Bern Universtiy Hospital, University of Bern, Switzerland
,
Maximilian de Bucourt
5   Institute for Diagnostic and Interventional Radiology, Charité University Medicine Berlin, Germany
,
Tobias Philipp Meyl
6   Medical Department, Medical Strategy, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Abstract

Objective To estimate the human resources required for a retrospective quality review of different percentages of all routine diagnostic procedures in the Department of Radiology at Bern University Hospital, Switzerland.

Materials and Methods Three board-certified radiologists retrospectively evaluated the quality of the radiological reports of a total of 150 examinations (5 different examination types: abdominal CT, chest CT, mammography, conventional X-ray images and abdominal MRI). Each report was assigned a RADPEER score of 1 to 3 (score 1: concur with previous interpretation; score 2: discrepancy in interpretation/not ordinarily expected to be made; score 3: discrepancy in interpretation/should be made most of the time). The time (in seconds, s) required for each review was documented and compared. A sensitivity analysis was conducted to calculate the total workload for reviewing different percentages of the total annual reporting volume of the clinic.

Results Among the total of 450 reviews analyzed, 91.1 % (410/450) were assigned a score of 1 and 8.9 % (40/450) were assigned scores of 2 or 3. The average time (in seconds) required for a peer review was 60.4 s (min. 5 s, max. 245 s). The reviewer with the greatest clinical experience needed significantly less time for reviewing the reports than the two reviewers with less clinical expertise (p < 0.05). Average review times were longer for discrepant ratings with a score of 2 or 3 (p < 0.05). The total time requirement calculated for reviewing all 5 types of examination for one year would be more than 1200 working hours.

Conclusion A retrospective peer review of reports of radiological examinations using the RADPEER system requires considerable human resources. However, to improve quality, it seems feasible to peer review at least a portion of the total yearly reporting volume.

Key Points: 

  • A systematic retrospective assessment of the content of radiological reports using the RADPEER system involves high personnel costs.

  • The retrospective assessment of all reports of a clinic or practice seems unrealistic due to the lack of highly specialized personnel.

  • At least part of all reports should be reviewed with the aim of improving the quality of reports.

Citation Format

  • Maurer MH, Brönnimann M, Schroeder C et al. Time Requirement and Feasibility of a Systematic Quality Peer Review of Reporting in Radiology. Fortschr Röntgenstr 2021; 193: 160 – 167

Zusammenfassung

Zielsetzung Ziel dieser Studie war es, den Aufwand für eine retrospektive Qualitätsprüfung mittels des RADPEER-Systems für verschiedene Prozentsätze der Gesamtmenge an radiologischen Befunden in der Klinik für Radiologie an der Universitätsklinik Bern (Schweiz) abzuschätzen.

Material und Methoden Drei Fachärzte für Radiologie (Bewerter 1 bis 3) bewerteten retrospektiv die Qualität der Befunde von insgesamt 150 radiologischen Untersuchungen (5 verschiedene Untersuchungsarten: Computertomografie (CT) des Abdomens, CT des Thorax, Mammografien, konventionelle Röntgenbilder und abdominale Magnetresonanztomografien (MRT)). Jedem Befund wurde eine RADPEER-Bewertung der Kategorien 1 bis 3 zugewiesen (Kategorie 1: stimmt mit der vorherigen Interpretation überein; Kategorie 2: Diskrepanz in der Interpretation/Beurteilung wäre nicht in jedem Fall zu erwarten gewesen; Kategorie 3: Diskrepanz in der Interpretation/Beurteilung wäre in den meisten Fällen zu erwarten gewesen) und die für jede Überprüfung erforderliche Zeit in Sekunden (s) dokumentiert. Die durchschnittliche Zeit für jede der 5 verschiedenen radiologischen Untersuchungsarten und die entsprechenden Bewertungen von 1 bis 3 wurden verglichen. Eine Sensitivitätsanalyse wurde durchgeführt, um die Gesamtarbeitsbelastung für die Überprüfung verschiedener Prozentsätze des gesamten jährlichen Befundvolumens der Klinik zu berechnen.

Ergebnisse Von den insgesamt 450 analysierten Befunden erhielten 91,1 % (410/450) eine Bewertung von 1 und 8,9 % (40/450) eine Bewertung von 2 oder 3. Die durchschnittliche Zeit (in Sekunden) für eine Bewertung betrug 60,4 s (min. 5 s, max. 245 s). Der Bewerter mit der längsten klinischen Erfahrung benötigte signifikant weniger Zeit für die Prüfung der Befunde als die beiden Gutachter mit kürzerer klinischer Erfahrung (p < 0,05). Die durchschnittlichen Bewertungszeiten waren länger für nicht übereinstimmende Bewertungen mit den Kategorien 2 oder 3 (p < 0,05). Der Gesamtzeitaufwand für die Überprüfung sämtlicher Befunde der 5 verschiedenen Untersuchungsarten eines Jahres würde mehr als 1200 Arbeitsstunden in Anspruch nehmen.

Schlussfolgerung Eine retrospektive Begutachtung von radiologischen Befundberichten mit dem RADPEER-System erfordert erhebliche personelle Ressourcen. Um die Befundqualität zu verbessern, scheint es jedoch möglich zu sein, zumindest einen Teil der Gesamtbefundungsleistung auch großer radiologischer Abteilungen routinemäßig einer Zweitbegutachtung zu unterziehen.

Kernaussagen: 

  • Eine systematische retrospektive inhaltliche Begutachtung von radiologischen Befunden mit dem RADPEER-System ist mit einem hohen Personalaufwand verbunden.

  • Die retrospektive Begutachtung sämtlicher Befunde einer Klinik bzw. Praxis erscheint aufgrund des Mangels an hochspezialisiertem Personal unrealistisch.

  • Mit dem Ziel der inhaltlichen Qualitätsverbesserung sollte jedoch zumindest ein Teil aller Befunde einer zweiten retrospektiven Begutachtung unterzogen werden.

Key words

socioeconomic issues - CT - mammography - radiography - health policy and practice - MR imaging


Publication History

Received: 12 January 2020

Accepted: 04 May 2020

Article published online:
22 July 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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