Canadian CT review finds 180 discrepancies

Canadian authorities have completed the review of CT scan reads performed by one radiologist at St. Joseph’s General Hospital in Comox and alerted patients and physicians to significant discrepancies in 180 scans.

The Vancouver Island Health Authority (VIHA) has been supporting St. Joseph’s General Hospital (SJGH) with the review since Feb. 14.

CT scans performed and read by the radiologist from August 2009 to January 2011 were re-read. The review involved a total of 2,721 CT scans, affecting 2,312 patients.

Of the 2,721 scans that were categorized, no significant discrepancies were found in 2,541 scans, with significant discrepancies noted in 180 scans. Affected patients and their physicians have been notified and further diagnostic tests and discussions regarding treatment paths are under way, according to VIHA.

The review found that the frequency of discrepancies was low during most of the period covered by the review, rising around December 2010 when it was first identified by SJGH as a concern. The reason for this change is not known.

Every CT image involved in the review was re-read by a radiologist external to SJGH. The external reads were done in an anonymous fashion. The second read report was then sent, along with the original report, to a third radiologist who acted as an adjudicator by reviewing both reports and determining if a discrepancy existed. In cases where there were significant discrepancies, a further discussion and assessment took place involving three or more radiologist adjudicators working as a group.

Patients whose scans were involved in the review have been contacted, the agency stated

SJGH and VIHA will work with Doug Cochrane, MD, provincial patient safety and quality officer and chair of the British Columbia Patient Safety and Quality Council, throughout the review process to determine next steps. The organizations will cooperate in the broader province-wide review, including strengthening quality control mechanisms, establishing formal peer-review processes, allowing for random re-reads of scans and putting in place performance reviews as part of the appointment process for medical staff.

The full review is expected in August 2011, and a review into reads involving other imaging modalities, including x-ray, ultrasound and mammography is still under way and should conclude at the end of April.

 

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