A retrospective review of all overreads from July 1, 2012, to June 30, 2015, was performed. Discrepancy rates for RFs and NRs were calculated. Error significance for cases requiring addenda was categorized as follows: acute, likely malignant, indeterminate, unlikely to be of clinical significance, insignificant typographic error, or significant typographic error.
In total, 10,796 studies were rechecked, of which 1.9% (n = 205) required addenda, 3.6% (n = 384) were deemed addendum-optional, and 94.5% (n = 10,207) required no comments. There was no significant difference in cases requiring addenda (RFs, 1.7% [119 of 6,847]; NRs, 2.2% [86 of 3,949]; P = .11). Of the 205 cases requiring addenda, 21.0% (n = 43) were deemed to be acute, 4.9% (n = 10) likely malignant, 28.3% (n = 58) indeterminate, 32.7% (n = 67) unlikely to be of clinical significance, and 13.1% (n = 27) secondary to typographic errors (66.7% [n = 18] deemed to be significant).
After-hours coverage with RFs and NRs allows high-quality final, actionable interpretations with low discrepancy rates and no significant difference between both groups for addendum-needed cases. The program strikes a balance between the need for timely interpretations and the need to continually monitor and improve the quality of interpretations through subspecialist feedback.