Reinterpretation of Hepatopancreaticobiliary Imaging Exams: Assessment of Clinical Impact, Peer Learning, and Physician Satisfaction

Gregory S Photopoulos; Darcie S Wilson; Sharon E Clarke; Andreu F Costa

doi:10.1016/j.acra.2023.10.047

Reinterpretation of Hepatopancreaticobiliary Imaging Exams: Assessment of Clinical Impact, Peer Learning, and Physician Satisfaction

Acad Radiol. 2024 May;31(5):1870-1877. doi: 10.1016/j.acra.2023.10.047. Epub 2023 Dec 4.

Authors

Gregory S Photopoulos¹, Darcie S Wilson¹, Sharon E Clarke², Andreu F Costa³

Affiliations

¹ Faculty of Medicine, Dalhousie University, 5849 University Avenue, Halifax, NS B3H 4R2, Canada (G.S.P., D.S.W., S.E.C., A.F.C.).
² Faculty of Medicine, Dalhousie University, 5849 University Avenue, Halifax, NS B3H 4R2, Canada (G.S.P., D.S.W., S.E.C., A.F.C.); Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre, Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, NS B3H 2Y9, Canada (S.E.C., A.F.C.).
³ Faculty of Medicine, Dalhousie University, 5849 University Avenue, Halifax, NS B3H 4R2, Canada (G.S.P., D.S.W., S.E.C., A.F.C.); Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre, Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, NS B3H 2Y9, Canada (S.E.C., A.F.C.). Electronic address: andreufcosta@gmail.com.

PMID: 38052671
DOI: 10.1016/j.acra.2023.10.047

Abstract

Objectives: To assess the impact on clinical management, potential for peer learning, and referring physician satisfaction with subspecialist reinterpretations of hepatopancreaticobiliary (HPB) imaging examinations.

Materials and methods: HPB CTs and MRIs from outside hospitals were reinterpreted by two subspecialty radiologists between March 2021 and August 2022. Reinterpretation reports were mailed to radiologists that issued primary reports. The electronic record was reviewed to assess for changes in clinical management based on the reinterpretations (yes/no/unavailable). To assess the potential for peer learning, a survey using a 5-point Likert scale was sent to radiologists who issued primary reports. A separate survey was sent to referring physicians to assess satisfaction with reinterpretations.

Results: Two hundred fifty imaging examinations (122 CT, 128 MRI) were reinterpreted at the request of 19 referring physicians. Ninety-six radiologists issued primary reports. RADPEER scores 1-3 were assigned to 131/250 (52%), 86/250 (34%), and 33/250 (13%) examinations, respectively. Of 213 reinterpretations with adequate records for assessment, 75/213 (35%) were associated with a change in management; of these, 71/75 (95%) were classified as RADPEER 2 or 3. Most radiologists agreed or strongly agreed with the following: prefer to receive reinterpretations (34/36, 94%); reinterpretations changed practice of reporting HPB imaging examinations (23/36, 64%); and reinterpretations offer opportunities for peer learning (34/36, 94%). Referring physicians agreed or strongly agreed (7/7, 100%) that reinterpretations are valuable and often change or clarify management of patients with complex HPB disease, and offer an opportunity for peer learning.

Conclusion: Radiologists and referring physicians strongly agree that HPB imaging reinterpretations help support peer learning and patient management, respectively.

Keywords: Hepatopancreaticobiliary disease; Peer learning; Radiology; Reinterpretation; Second opinion.

MeSH terms

Biliary Tract Diseases / diagnostic imaging
Female
Humans
Liver Diseases / diagnostic imaging
Magnetic Resonance Imaging
Male
Middle Aged
Pancreatic Diseases / diagnostic imaging
Physician Engagement
Referral and Consultation*
Surveys and Questionnaires
Tomography, X-Ray Computed