Rate of Significant Misses in Resident Preliminary CT Head On-Call Reports
Bibliographic record
Abstract
Abstract # 151TitleRate of Significant Misses in Resident Preliminary CT Head On-Call ReportsAuthorsJ. Cai (PGY-4), J. Chankowsky, J. TaylorObjective: To determine the rate and most common clinically significant misses in radiology residentsu2019 on-call CT head C- reports at our institution. MethodsThis retrospective study reviewed 848 cases of CT head without IV contrast performed during on call hours on the 1st, 12th, and 24th day of every month between July 1, 2017 and June 30, 2018 at two university hospital sites u2013 the Montreal General Hospital and Royal Victoria Hospital. Final radiology staff report was used as standard and only RADPEER type 3 and 4 misses were included. All identified and equivocal cases were reviewed by a subspecialty neuroradiologist. ResultsOut of 848 cases reviewed, 12 cases were identified to contain either a RADPEER type 3 or 4 miss, a miss rate of 1.4%. Out of the 12 cases, 4 cases were each missed by PGY-2, PGY-3, and PGY-4 residents on call respectively. None of the cases were missed by a PGY-5 resident during call. Our institution has a graded call system with call duty more heavily distributed to PGY-2 and PGY-3 residents than PGY-4 and PGY-5 residents. Therefore, frequency of clinically significant misses by training level is expressed as the number of calls per missed finding, with 9.25 calls, 14.25 calls, and 8 calls for PGY-2, 3, and 4 respectively. The most frequently missed findings were subdural hygroma with mass effect in acute trauma (25%), acute ischemia (25%), calvarial fracture (17%), and new hydrocephalus (17%). ConclusionRate of RADPEER type 3 and 4 misses in radiology resident on call preliminary reports for CT Head C- within our institution was 1.4%, no higher than that published in literature. The most frequently missed findings were traumatic subdural hygroma, acute ischemia, calvarial fracture and new hydrocephalus. None of the significant findings were missed by PGY-5 residents. Otherwise, there is no correlation between the level of training and frequency of significant missed findings on CT head C-.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.020 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".