An audit of local discrepancy rates in acute abdominal CT: does subspecialist reporting reduce discrepancy rates?

Aim To assess the discrepancy rates (DR) for patients undergoing abdominopelvic computed tomography (CT) for acute non-traumatic abdominal pain who have a subsequent emergency laparotomy in a large university teaching hospital, in particular identifying the differences between subgroups of reporters, to assess factors that may influence the discrepancy rates, to examine the pathologies with the highest discrepancy rate, to identify learning points, and give recommendations on current practice. Materials and methods The surgical data and CT reports of 1,176 patients who underwent urgent laparotomy after CT from 2014–2018 in a large university hospital were analysed retrospectively. A major discrepancy was defined as an error of fact in the radiology report, which led to incorrect management or patient harm. Results Registrars have higher DR than consultants (6.86% versus 2.77%). The major DR for consultants met national standards ( Conclusions DR for registrars and consultants are below the national audit standard. Several factors associated with a lower DR in acute abdominopelvic CT were also identified, including reporting by consultants, reporting by GI radiologists and preoperative discussions between the radiologist and surgeon.