Midnight Misses: Imaging Addenda and Pediatric Outcomes

Background: Radiology misreads can adversely impact healthcare delivery, leading to delays in care, suboptimal interventions, or harm through inappropriate discharge or procedures. This ongoing project investigates the frequency of addenda in radiology reports, the underlying reasons for addenda, and their clinical implications for patient care. This study analyzes 1,692 pediatric trauma patients seen in the emergency department at Children’s Hospital of Michigan (CHM) between January 2022 and December 2023. Key variables include: interpreter PGY level, anatomic location, imaging modality, time of reads, severity and type of misinterpretation (e.g., false negatives/positives), and clinical outcomes. Hypothesis: Our hypothesis posits that pediatric trauma patients seen in the emergency room at night will have higher rates of addenda to their radiology reports indicating a misread of the original report, which will lead to worse clinically significant events. Methods: Preliminary data collection includes patient demographics (age, gender, race/ethnicity, and home location) and chart reviews to assess defined variables. Statistical analysis is pending to confirm these patterns and their implications. We currently have defined our variables and begun our chart review. We have yet to obtain all information from patient charts and complete a statistical analysis of this data to draw conclusions from this information. Significance: The study's significance lies in identifying factors contributing to misreads, such as trauma settings or after-hours interpretations by residents, and their impact on patient outcomes. This research aims to inform strategies to reduce radiology misreads, improve care quality and reduce morbidity and mortality in pediatric trauma patients.