Merchant SA, Merchant N. Letter to the Editor: Beyond the audit, real-time data integration and dedicated clinical oversight in diagnostic reconciliation. World J Clin Cases 2026; 14(16): 119871 [DOI: 10.12998/wjcc.v14.i16.119871]
Corresponding Author of This Article
Suleman A Merchant, Department of Radiology, LTM Medical College and LTM General Hospital, Sion, Mumbai 400022, Maharashtra, India. suleman.a.merchant@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Correspondence
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Merchant SA, Merchant N. Letter to the Editor: Beyond the audit, real-time data integration and dedicated clinical oversight in diagnostic reconciliation. World J Clin Cases 2026; 14(16): 119871 [DOI: 10.12998/wjcc.v14.i16.119871]
Letter to the Editor: Beyond the audit, real-time data integration and dedicated clinical oversight in diagnostic reconciliation
Suleman A Merchant, Neesha Merchant
Suleman A Merchant, Department of Radiology, LTM Medical College and LTM General Hospital, Mumbai 400022, Maharashtra, India
Neesha Merchant, Department of Diagnostic Radiology, Medical Imaging, University of Toronto, Toronto M5G 2C4, Ontario, Canada
Author contributions: Merchant SA contributed to conceived the editorial concept, developed the central analytical framework, drafted the original manuscript, and was responsible for all substantive intellectual content including the clinical governance analysis, the Large Concept Models integration, and the critical appraisal of the Virarkar et al initiative; Merchant N assisted in the compilation and formatting of the manuscript, verified and organised the reference list, and contributed to the preparation of the final submission; both authors have read and approved the final version of the manuscript.
AI contribution statement: No AI tool was used. The manuscript was written by all authors.
Conflict-of-interest statement: The authors declare no financial conflicts of interest related to this work.
Corresponding author: Suleman A Merchant, Department of Radiology, LTM Medical College and LTM General Hospital, Sion, Mumbai 400022, Maharashtra, India. suleman.a.merchant@gmail.com
Received: February 24, 2026 Revised: March 9, 2026 Accepted: April 23, 2026 Published online: June 6, 2026 Processing time: 97 Days and 22.5 Hours
Abstract
Diagnostic disagreements between clinical and diagnostic services represent a critical blind spot in modern hospital management, often leading to treatment delays and compromised clinical trial integrity. While retrospective audits have traditionally been used to identify these gaps, they lack the agility required for real-time patient safety. This article examines the findings of Virarkar et al in their manuscript titled “Impact of a dedicated consult shift on reducing time to resolution of diagnostic disagreements: A quality improvement initiative” which introduces a dual-strategy intervention-the implementation of a dedicated consult shift combined with a real-time digital dashboard. The reported reduction in median resolution times from 20.90 to 5.02 days-a 76% improvement-represents a noteworthy demonstration that the friction of diagnostic disagreement may be amenable to structured logistical redesign. We discuss how this framework may be adapted across high-stakes specialties, including Radiology, subject to appropriate institutional prerequisites, to support the transition of diagnostic reconciliation from a passive administrative task to a proactive clinical safeguard. Unresolved diagnostic discordance may affect patient eligibility classification, endpoint interpretation, and protocol adherence in clinical trials-mechanisms through which diagnostic disagreement can compromise trial validity and which merit further investigation in the context of this intervention.
Core Tip: This article examines a quality improvement initiative by Virarkar et al utilizing a dedicated consult shift and real-time digital dashboards to resolve diagnostic disagreements. The dual-strategy model achieved a 76% reduction in median resolution time. Successful replication of this approach would require institutional prerequisites including digital infrastructure maturity, interoperability of electronic systems, and clearly defined accountability structures.
