Perceptual errors in pediatric radiology

Abstract

Perceptual errors are common contributors to missed diagnoses in the clinical practice of radiology. While the physical attributes of an image such as image resolution, signal-to-noise characteristics, and anatomic complexity are major causes of poor conspicuity of pathologic lesions, there are major interrelated cognitive contributors to visual errors. The first is satisfaction of search (SOS), where the detection of an abnormality results in premature termination of further search. Another form of incomplete search pattern is visual isolation, where a radiologist's search pattern is truncated to the main areas of an image, while little or no attention is given to peripheral areas. A second cognitive error is inattentional blindness, defined as the failure to notice a fully visible, but unexpected object because attention was otherwise engaged. Strategies for error mitigation have centered around the use of check lists, self prompting routines, and structured reporting within an institutional culture of safety and vigilance.

Easily missed pathologies of the musculoskeletal system in the emergency radiology setting

“…Other factors include a level of experience on the part of the reader (most on-call duties are performed by radiologists in training) and image interpretation under stressful conditions in the emergency room [10], lack of clinical information, absence of previous imaging studies, suboptimal reading room atmosphere, multitasking and increased workload [10] all factors that are often typical of on-call duties and night and weekend shifts. Another human factor is perceptual errors when reporting radiological images [33,34]. The 'satisfaction of search' error [8,11] (▶ Table 1), where the detection of an abnormality results in premature termination of the search for further issues, is one of these.…”

Diagnosing Crime and Diagnosing Disease‐II: Visual Pattern Perception and Diagnostic Accuracy

“…This finding parallels Littlefair's experimental eye tracking data. Such “satisfaction of search” is another instance of how prior information misleads .…”

Improving diagnosis in radiology – progress and proposals

“…George Taylor [7] provides two contributions to this special issue, one being the enchanting X-ray art images that grace the intermediary pages. For those of us who see X-rays used only for medical imaging, Taylor's X-ray images of objects from nature are at once striking and beautiful.…”

“…For those of us who see X-rays used only for medical imaging, Taylor's X-ray images of objects from nature are at once striking and beautiful. His artistic contribution is matched by an academic one, a comprehensive review of perceptual error in Radiology -why seemingly obvious findings are missed [7]. Using examples from his work in pediatric radiology, the major etiologies are explored and illustrated.…”