INFLUENCE OF PRIOR RADIOLOGIC INFORMATION ON THE INTERPRETATION OF RADIOGRAPHIC EXAMINATIONS

Rationale and Objectives. We examined whether and how the provision of previous radiologic information (previous films and reports) influenc es the interpretation of radiographs. Methods. We prospectively studie d 35 radiologists' interpretation of 311 plain-film radiology cases in a clinical setting. A radiologist first interpreted the current radio graph with only the information given on the consultation request. Sub sequently, the same radiologist received, in random order, either the previous radiographs or the previous written reports, reviewed the dia gnosis, changing it when necessary, noted the recognition of new findi ngs, and adjusted his or her degree of confidence. A third interpretat ion used whichever type of information was not supplied for the second . All three readings of a study were performed at the same sitting by the same radiologist. A diagnosis and degree of confidence were record ed for each reading. Results. The additional information, either radio graph or written report, significantly increased the confidence of the radiologist at each stage of interpretation. The largest increase in confidence occurred whenever previous films were introduced. In group A (second reading, reports; third reading, old films), new observation s were made in 17.3% of cases on the second reading and in 19.9% on th e third reading. In this group, diagnoses were changed in 14% on the s econd reading and in 9% on the third reading. In group B (second readi ng, old films; third reading, old reports), new observations were made in 16.9% of cases on the second reading and 7.3% on the third reading . Diagnoses were changed in 11% on the second reading and in an additi onal 5% on the third reading. Most changes were toward a more specific diagnosis. Conclusion. Prior information significantly increased the radiologists' confidence, facilitated new observations, and allowed mo re specific diagnoses. Prior radiographs were more valuable than repor ts in some respects.