Date of Award

2008

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Howard Forman

Abstract

The purpose of this study was to evaluate the impact of a teleradiology service on the timely interpretation of computed tomography (CT) pulmonary angiography studies. A survey of clinical and imaging physicians was performed to develop achievable goals for interpretation of CT pulmonary angiography studies. Percentages of studies given preliminary written reports within these thresholds were compared for 1,102 pulmonary angiography CT studies from three months before teleradiology was implemented to three months after. Identical control data were matched over the same periods for 1,638 CT brain studies. Data are reported as averages and percentages. Statistical significance was evaluated with two-tailed t-tests. The median of the optimal time for the preliminary written interpretation of a pulmonary angiography CT reported by radiology chairs or their designees was 60 minutes versus 20 minutes for emergency medicine physicians, who also reported a 40-minute limit for an acceptable interpretation time. There were statistically significant improvements in the percentage of these studies interpreted within 60-minute (51 percent to 62 percent) and 20-minute (nine percent to thirteen percent) optimal time thresholds, within the 40-minute acceptable time threshold (34 percent to 43 percent), and in the percentage of studies taking greater than 40 minutes (67 percent to 57 percent). No statistically significant improvement occurred with control CT brain studies. The use of teleradiology to interpret off-hours inpatient imaging can improve imaging study interpretation times. By establishing an agreed-upon time standard for preliminary written reports of such exams, radiologists and treating physicians can collaborate to ensure prompt diagnosis and treatment of potentially lethal illnesses, such as pulmonary embolism.

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