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Radiologists Read More Complex Studies in Higher Acuity Settings Than Nonradiologists

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Complex studies in higher acuity patients are more likely to be interpreted by radiologists than nonradiologists.

Radiologists interpret more complex studies in higher acuity settings than do nonradiologists, according to a study published in The Journal of the American College of Radiology.

Researchers from Massachusetts General Hospital in Boston, Neiman Health Policy Institute in Reston, Virginia, and Emory University School of Medicine in Atlanta sought to determine differences between the work of radiologists and nonradiologists as they interpret lower extremity venous duplex ultrasound (LEVDU) examinations.

The researchers reviewed LEVDU 760,433 examinations carrier claims files for a 5 percent national sample of Medicare beneficiaries from 2012 to 2015. They retrospectively classified the examinations whether performed by radiologist or nonradiologist, weekday versus weekend, site of service, and patient Charlson Comorbidity Index (CCI) scores.


Radiologists vs. Nonradiologists

  • Total number of cases interpreted 439,964 (58%) vs. 320,469 (42%)
  • Weekend interpretations 75% (66,094 of 88,244) vs. 25% (22,150 of 88,244)


Fifty-seven percent of the LEVDU examinations performed in inpatient or emergency department settings were interpreted by radiologists; 70 percent of LEVDU examinations interpreted by nonradiologists were performed in the private office or outpatient hospital setting. Radiologists also interpreted more of their examinations (17 percent) on patients who had more comorbidities (CCI of ≥3) than did nonradiologists (15 percent).

The researchers concluded that radiologists interpret more examinations performed on weekends, in higher acuity settings, and among patients with more comorbidities than do nonradiologists. “To optimize around-the-clock patient access to necessary imaging, emerging quality payment programs should consider the timing and sites of service, as well as patient complexity,” they wrote.

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