Discordance of community and hospital ultrasound reports for urological abnormalities

Introduction: In Ontario, community ultrasound clinics do not require the onsitepresence of a radiologist at the time of imaging. In hospitals, a radiologistis always present for this step. We compared the discrepancy rate of communityand hospital ultrasound reports in a urology practice.Materials and Methods: We retrospectively reviewed the charts of patients whohad abdominal ultrasound performed in the community and in the hospital between April 1, 2001 and June 30, 2005. Reports were examined for indication, findings and whether there was a discrepancy. A medical student, a resident,and a staff physician each independently reviewed the findings.Results: One hundred and twenty-two patients had abdominal ultrasound performed in the community and were followed up with hospital imaging. Sixty-nine patients had a community ultrasound followed by hospital ultrasound,with a discordance rate of 52.2%. Fifty-three patients had a community ultrasoundand then a hospital CT scan, with a discordance rate of 43.3%. Of patientswith discordant ultrasound reports, 23 had an additional CT scan in whichall findings were consistent with the hospital ultrasound findings.Discussion: We found a very high discordance rate between community and hospital ultrasound reports. This is consistent with a study showing that theactive role of the radiologist in ultrasound imaging is very important for accurate reporting.