Second Opinions Changed Management and Care for 92% of Patients

The conclusion of a 2022 study examined the benefits of having a second opinion performed on radiology imaging exams for patients being transferred from an emergency room to a Level 1 trauma center. The study determined the additional information provided by the second opinions were worth the effort to routinely have second opinions performed when accepting transferred emergency patients. The University of Washington in Seattle study tracked nearly 6,000 patients during 2018 that were transferred to the UW Medicine Level 1 trauma center. The study specifically examined discrepancies between the transferred patients reports for MRI and CT scans that were performed outside the trauma center versus the routine overreads performed by the emergency subspecialty radiologists at the trauma center.  Overreads in radiology occur when a radiologist reviews a patients' advanced imaging exam after an interpretation, or radiology report, has already been made by another radiologist.

While second opinion overreads occur in many scenarios within medical institutions who receive transferred patients, the goal of this study was to examine the impact of these second opinions and to see if having a second opinion on the radiology imaging exams would change the management and care for these patients.

The results over a 12-month period showed that 12% of the overreads found at least one discrepancy between the original report and the secondary interpretation. These discrepancies resulted in a different course of action/treatment plan for 92% of the patients, with 81% of the patients requiring an extended Emergency Department stay.

The study also determined that even when the overread found no discrepancies, the second opinion performed by the emergency department's subspecialty radiologist often gave the emergency team of providers additional information beyond what the original report provided that could help the team deliver better care to the patient. The authors of the study concluded the changes in the patient care that resulted from these second opinions were deemed beneficial enough to support effort implement workflows to routinely execute second opinions on advanced imaging exams for emergency transfer patients. 

While this study specifically examined radiology second opinions for emergency transfer patients, the biggest takeaway is the value these second opinions had on the care and management of the patient. Radiology reports are the foundation for your specialists' decisions on your treatment plan. By getting a second opinion from a subspecialty radiologist, your physician can be armed with additional information that may change the course of your treatment.

Reference to the full study:
 "Transfer Patient Imaging: Assessment of the Impact of Discrepancies Identified by Emergency Radiologists.” Journal of the American College of Radiology, Aug. 13, 2022. DOI:

Study Authors: 
Jeffrey D. Robinson, MD, MBA, Ross Kessler, MD, Michael E. Vrablik, DO, Marie C. Vrablik, MD, MCR, Daniel S. Hippe, MS, M. Kennedy Hall, MD, MHS, Steven H. Mitchell, MD, Ken F. Linnau, MD, MS

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