Serious discrepancies between preliminary imaging reads and final radiology reports are at risk of accumulating when the prelims are rendered during overnight hours, according to a study conducted at Indiana University and published in Emergency Radiology [1].

The team further found that, for advanced imaging studies in particular, initial daytime interpretations tend to have much lower discrepancy rates with final reports.

They suggest that, considered together, the findings underscore the wisdom of optimizing overnight reading conditions and, as clinical circumstances permit, delaying advanced imaging acquired overnight for reading during the day.

Senior researcher Suzanne Chong, MD, and colleagues reviewed data spanning 5.9 million imaging exams performed for neuroradiology, abdominal radiology and musculoskeletal indications.

All exams had been read by teleradiologists with fellowship training in one of those subspecialties and by onsite radiologists working at the telepractice’s client hospitals.

Comparing first and final reads, Chong and team found common imaging studies were initially misinterpreted overnight at a rate of 0.14%. This was only somewhat worse than daytime (0.13%) and evening (also 0.13%) reads of common studies.

However, for advanced imaging studies, daytime had significantly lower major discrepancy rates, 0.15%, compared to overnight, 0.23%. Evening reads landed in the middle at 0.20%.

In their discussion, Chong and co-authors remark that significantly higher major discrepancy rates for studies interpreted overnight “suggest the need for radiologists to exercise greater caution when interpreting studies overnight and may require practice management strategies to help optimize overnight work conditions.”

The lower major discrepancy rates on advanced studies interpreted during the daytime, they add, “suggest the need for reserving advanced studies for interpretation during the day when possible.”

Study abstract here, full text behind paywall.