Patients’ data were obtained using QPID (queriable patient inference dossier), which is a health intelligence platform incorporating an electronic health record search engine in our hospital. This study followed the Health Insurance Portability and Accountability Act guidelines and was approved by our institutional review board. The inclusion criteria were: 1) patients with a cervical spine CT at an outside facility with available radiology report, 2) adults (age ≥18 years), 3) having a history of trauma as an indication for requesting cervical spine CT, and 4) request to the radiology service (by the referring physician in our hospital) for a second-opinion consultation on the outside CT scans. We performed a retrospective analysis of 301 consecutive cases with cervical spine CT who were referred to our institution, over a period of 16 months from March 2011 to July 2012. The purpose of this study was to evaluate the effectiveness of second-opinion radiology consultations to reassess the cervical spine CT scans of the trauma patients referred to our hospital. Spine injuries are frequently missed therefore, a second opinion can potentially improve the diagnosis ( 5). Despite all the advantages of multidetector CT, suspected spinal injury continues to be a daily challenge in clinical practice ( 4). Multidetector CT is an essential part of the assessment of patients suspected of having cervical spine injury after trauma. The added value of the point-of-care second interpretations can be viewed from the medical perspective of guiding and expediting appropriate treatment as well as from the financial perspective of avoiding unnecessary studies, at times incurring additional patient radiation exposure, when initial examinations need to be repeated or when additional examinations are suggested by the radiologist at an outside institution ( 3). As part of the care to be delivered by the radiologists at the referral center, a second-opinion interpretation of the imaging studies is often requested, and the formal reports are incorporated into the patient’s permanent medical record at the referral institution where the patient’s management and treatment are determined. Patients referred to the tertiary care centers often arrive with radiologic imaging having already been performed at the primary institution. Some medical errors are extremely costly particularly with respect to patient morbidity and mortality. Public attention and awareness have increased and amplified the focus on the quality of healthcare ( 2). The quality of healthcare has become a target of increasing public scrutiny and governmental concern while radiologic evaluation has assumed an increasingly important role in the diagnosis and management of patients ( 1).
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