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      Added value of double reading in diagnostic radiology,a systematic review

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          Abstract

          Objectives

          Double reading in diagnostic radiology can find discrepancies in the original report, but a systematic program of double reading is resource consuming. There are conflicting opinions on the value of double reading. The purpose of the current study was to perform a systematic review on the value of double reading.

          Methods

          A systematic review was performed to find studies calculating the rate of misses and overcalls with the aim of establishing the added value of double reading by human observers.

          Results

          The literature search resulted in 1610 hits. After abstract and full-text reading, 46 articles were selected for analysis. The rate of discrepancy varied from 0.4 to 22% depending on study setting. Double reading by a sub-specialist, in general, led to high rates of changed reports.

          Conclusions

          The systematic review found rather low discrepancy rates. The benefit of double reading must be balanced by the considerable number of working hours a systematic double-reading scheme requires. A more profitable scheme might be to use systematic double reading for selected, high-risk examination types. A second conclusion is that there seems to be a value of sub-specialisation for increased report quality. A consequent implementation of this would have far-reaching organisational effects.

          Key Points

          • In double reading, two or more radiologists read the same images.

          • A systematic literature review was performed.

          • The discrepancy rates varied from 0.4 to 22% in various studies.

          • Double reading by sub-specialists found high discrepancy rates.

          Electronic supplementary material

          The online version of this article (10.1007/s13244-018-0599-0) contains supplementary material, which is available to authorised users.

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          Most cited references160

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          Diagnosis of Extracapsular Extension of Prostate Cancer on Prostate MRI: Impact of Second-Opinion Readings by Subspecialized Genitourinary Oncologic Radiologists.

          Andreas Wibmer, Hebert Vargas, Timothy Donahue … (2015)
          The purpose of this article is to investigate the added value of second-opinion evaluation of prostate MRI by subspecialized genitourinary oncologic radiologists for the assessment of extracapsular extension (ECE) of prostate cancer.
          Article 0 comments Cited 30 times – based on 0 reviews     Review now
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            Accuracy of unenhanced MR imaging in the detection of axillary lymph node metastasis: study of reproducibility and reliability.

            Riham Eiada, Lindsay Jacks, Anabel M Scaranelo … (2012)
            To investigate the accuracy, reproducibility, and reliability of unenhanced magnetic resonance (MR) imaging techniques for detecting metastatic axillary lymph nodes in patients with newly diagnosed breast carcinoma. Institutional review board approval and informed consent were obtained. Seventy-four consecutive women with invasive breast carcinoma were recruited to undergo preoperative breast MR imaging. Thirteen patients were excluded, two because they were undergoing preoperative chemotherapy and 11 because of the presence of movement or susceptibility artifacts on images. Thus, 61 patients (mean age, 53 years; range, 33-78 years) were included in this study. Axial T1-weighted MR images without fat saturation and diffusion-weighted (DW) MR images were analyzed by two experienced radiologists, who were blinded to the histopathologic findings. Visual and quantitative analyses of unenhanced MR images were performed. Sensitivity, specificity, and accuracy were calculated. To assess the intraobserver agreement, a second reading was performed. Statistical analysis was conducted on a patient-by-affected side basis. The sensitivity, specificity, and accuracy were 88%, 82%, and 85%, respectively, for axial T1-weighted MR imaging and 84%, 77%, and 80% for DW imaging. Apparent diffusion coefficients (ADCs) were significantly lower in the malignant group (P<.05 for all four readings), with the average of the four readings ranging from 0.333×10(-3) mm2/sec to 2.843×10(-3) mm2/sec. The mean Lin coefficient comparing the mean ADC reading for each observer was 0.959 (95% confidence interval: 0.935, 0.975), suggesting very high interobserver agreement between the two observers in terms of reproducibility of ADCs. The Bland-Altman plot showed good inter- and intraobserver agreement. Unenhanced MR imaging techniques showed high accuracy in the preoperative evaluation of axillary status in patients with invasive breast cancer. Results indicate reliable and reproducible assessment with DW imaging, but it is unlikely to be useful in clinical practice. © RSNA, 2011
            Article 0 comments Cited 29 times – based on 0 reviews     Review now
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              Development and evaluation of a new chest radiograph reading and recording system for epidemiological surveys of tuberculosis and lung disease.

              S den Boon, E Bateman, D Enarson … (2005)
              The development and evaluation of a new chest radiograph reading and recording system (CRRS) for community surveys of tuberculosis (TB) and lung disease. An experienced pulmonologist read 2608 chest X-rays (CXRs) performed as part of a TB prevalence survey using the newly developed CRRS. The kappa (kappa) for inter-reader agreement was calculated after a second reader reported on a stratified random sample of 810 (31%) of the 2608 CXRs. The kappa for intra-reader agreement was calculated from the repeated reporting of a stratified random sample of 104 CXRs. The kappa agreement between the two readers was 0.69 (95%CI 0.64-0.74) for abnormalities consistent with TB and 0.47 (95%CI 0.42-0.53) for any abnormalities. The kappa for intra-reader agreement was 0.90 (95%CI 0.81-0.99) for abnormalities consistent with TB and 0.85 (95%CI 0.74-0.95) for any abnormalities. This standardised method for CXR reading and recording provides satisfactory inter- and intra-reader agreement, making it suitable for surveys of TB and other forms of lung disease in the community. Its use will permit comparisons of results obtained in different surveys.
              Article 0 comments Cited 29 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Håkan Geijer:
                ORCID: http://orcid.org/0000-0003-3253-8967
                +46 19 6025032 , hakan.geijer@regionorebrolan.se
                Journal
                Journal ID (nlm-ta): Insights Imaging
                Journal ID (iso-abbrev): Insights Imaging
                Title: Insights into Imaging
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Electronic): 1869-4101
                Publication date (Electronic): 28 March 2018
                Publication date PMC-release: 28 March 2018
                Publication date Collection: June 2018
                Volume: 9
                Issue: 3
                Pages: 287-301
                Affiliations
                [1 ]ISNI 0000 0001 0738 8966, GRID grid.15895.30, Department of Radiology, Faculty of Medicine and Health, , Örebro University, ; 701 85 Örebro, Sweden
                [2 ]GRID grid.411843.b, Department of Radiology, , Skåne University Hospital and Lund University, ; Lund, Sweden
                Author information
                http://orcid.org/0000-0003-3253-8967
                Article
                Publisher ID: 599
                DOI: 10.1007/s13244-018-0599-0
                PMC ID: 5990995
                PubMed ID: 29594850
                SO-VID: 4ce726b2-ca51-40fb-a564-cfa704b6e2b1
                Copyright © © The Author(s) 2018
                License:

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 2 November 2017
                Date revision received : 10 January 2018
                Date accepted : 15 January 2018
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © The Author(s) 2018

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: diagnostic errors,observer variation,diagnostic imaging,review,quality assurance, healthcare
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: diagnostic errors, observer variation, diagnostic imaging, review, quality assurance, healthcare

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