Imaging Pearls ❯ Trauma ❯ Overview
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- Results: Over a 12-month period, 5,834 patients were accepted in transfer. Among 5,631 CT or MRI examinations with outside reports available, 669 examinations (12%) had at least one discrepancy in the corresponding outside report. In 219 examinations (33%), ED management was changed by discrepancies noted on the final report; patient disposition was affected in 84 (13%), outpatient follow-up in 54 (8%), and selection of consulting services in 411 (61%), and ED stay was extended in 544 (81%). Discrepant findings affected decision making in 613 of 669 of examinations (92%).
Conclusion: Emergency radiology overreading of transferred patients’ advanced imaging examinations provided actionable additional information to emergency medicine physicians in the care of 613 of 669 (92%) examinations with discrepant findings. This added value is worth the effort to design workflows to routinely overread CT and MRI examinations of ETPs.
Transfer Patient Imaging: Assessment of the Impact of Discrepancies Identified by Emergency Radiologists
Jeffrey D. Robinson et al.
J Am Coll Radiol 2022;19:1244-1252. 
Transfer Patient Imaging: Assessment of the Impact of Discrepancies Identified by Emergency Radiologists
Jeffrey D. Robinson et al.
J Am Coll Radiol 2022;19:1244-1252.- “We demonstrate the clinical impact of subspecialty emergency radiology identification of discrepancies with outside reports on patient care in the ED. This study supports findings of earlier studies showing an approximately 10% discrepancy rate between subspecialty emergency radiologist and community radiologist interpretations of transferred patients’ scans, with more than 80% of the differences occurring among trauma victims. To further improve patient care, health care systems must evolve technical improvements to facilitate the import of outside examinations into the PACS and include routine overread requests in EHR order sets. To drive this improvement, both emergency providers and radiologists must develop the understanding that these reports have value. Further study into the reimbursement of these reports is under way.”
Transfer Patient Imaging: Assessment of the Impact of Discrepancies Identified by Emergency Radiologists
Jeffrey D. Robinson et al.
J Am Coll Radiol 2022;19:1244-1252. - TAKE-HOME POINTS
• CT and MR reports of patients transferred to a level I trauma center contained significant discrepancies in 12% of cases.
• Emergency medicine providers received actionable information from 92% of overreads from emergency radiologists in cases with significant discrepancies.
• Routine subspecialty emergency radiology overreads of outside advanced imaging examinations of transferred patients change patient care by emergency medicine providers.
• Trauma centers should develop workflows to streamline overreading of transferred patients’ advanced imaging.
Transfer Patient Imaging: Assessment of the Impact of Discrepancies Identified by Emergency Radiologists
Jeffrey D. Robinson et al.
J Am Coll Radiol 2022;19:1244-1252.
- Trauma in the USA
- 100,000 deaths annually
- Leading cause of death age 1-44 years old
- Blunt trauma accounts for 70% of trauma cases, two-thirds of which are related to MVAs
- 300 billion dollar cost in the US each year