Radiological error: analysis, standard setting, targeted instruction and teamworking

Abstract

Diagnostic radiology does not have objective benchmarks for acceptable levels of missed diagnoses. Until now, data collection of radiological discrepancies has been very time consuming. The culture within the specialty did not encourage it. However, public concern about patient safety is increasing. There have been recent innovations in compiling radiological interpretive discrepancy rates which may facilitate radiological standard setting. However standard setting alone will not optimise radiologists' performance or patient safety. We must use these new techniques in radiological discrepancy detection to stimulate greater knowledge sharing, targeted instruction and teamworking among radiologists. Not all radiological discrepancies are errors. Radiological discrepancy programmes must not be abused as an instrument for discrediting individual radiologists. Discrepancy rates must not be distorted as a weapon in turf battles. Radiological errors may be due to many causes and are often multifactorial. A systems approach to radiological error is required. Meaningful analysis of radiological discrepancies and errors is challenging. Valid standard setting will take time. Meanwhile, we need to develop top-up training, mentoring and rehabilitation programmes.

Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists

“…Another form of peer review can be performed by giving an opinion on the degree of disagreement/discrepancy of the previous interpretation (old examinations) while performing a routine interpretation of the current study [3]. Discrepancy rates of radiological interpretation range widely (2-29%), degree of severity (mild to severe), and potential consequences to the patients [4][5][6]. The reasons for a wide range of frequency of discrepancy among different studies are differences in the methods of investigation, criteria used to define discrepancy, types of examination, and the different combination of cases.…”

The frequency of diagnostic errors in radiologic reports depends on the patient's age

“…Prior literature reviews indicate a high level of error within radiology (10,11). The etiology of radiologic error is multifactorial.…”

“…2010- [10][11] 3 Subspecialties in radiology are usually based on organ systems, i.a. musculoskeletal-, gastrointestinal-, and neuroradiology.…”

Error en el informe radiológico: La paradoja del elefante en la habitación y otros tropiezos

“…Se estima que el 90% de los cánceres detectados son visible en forma retrospectiva en las radiografías de meses o años atrás 11 . Teniendo en consideración que la sola variación intra-observador se ha estimado entre 10-20% 12 ; en la revisión de exámenes ajenos, el desacuerdo puede llegar a ser superior al 30% para informes efectuados por otro 13 . Otra forma de medir el error actualmente es cuantificando el número de adendum realizados a los informes en el sistema informático, el cual se ha estimado en un 0,8% 14 .…”