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

Abstract

Background: Patients who undergo treatment may suffer preventable medical errors. Some of these errors are due to diagnostic imaging procedures. Purpose: To compare the frequency of diagnostic errors in different age groups in an urban European population. Material and Methods: A total of 19 129 reported radiologic examinations were included. During a 6-month period, the analyzed age groups were: children (aged 0–9 years), adults (40–49 years), and elderly (86–95 years). Results: The frequency of radiologic examinations per year was 0.3 in children, 0.6 in adults, and 1.1 in elderly. Significant errors were significantly more frequent in the elderly (1.7%) and children (1.4%) compared with adults (0.8%). There were 60 false-positive reports and 232 false-negative reports. Most errors were made by staff radiologists after hours when they reported on examinations outside their area of expertise. Conclusion: Diagnostic errors are more frequent in children and the elderly compared with middle-aged adults.

Common patterns in 558 diagnostic radiology errors

“…21 Recent literature has suggested that errors are more common in young and elderly patients. 22 As our review is a random sample of the department workload we can not extrapolate this data further as to prevalence in different age groups but of note an error in a paediatric patient occurred more frequently if the reporting radiologist did not have paediatric subspecialist interest and cranial imaging accounted for 24% of these referrals.…”

Double reading rates and quality assurance practices in Norwegian hospital radiology departments: two parallel national surveys

“…Literature for international comparison is inadequate, but indicates substantial differences. One report from a university hospital in Sweden indicates that all exams are double read (4). In USA a random review of 5% of cases is required for credentialing by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (8).…”

“…Coupled with systematic analysis of discrepancies double reading may reveal patterns of errors in the work of individual readers, allowing for appropriate feedback about the need for further education (3). It is routinely employed in education and QA when resident radiologists read exams independently, but may benefit experienced and inexperienced radiologists alike (3–5). However, the cost efficiency of double reading has yet to be established (3).…”

“…In Scandinavian countries there is a tradition of extensively double reading, even exams read by consultant radiologists (4,10). This practice predates the introduction of Picture Archiving and Communications Systems (PACS).…”

Variability in diagnostic error rates of 10 MRI centers performing lumbar spine MRI examinations on the same patient within a 3-week period

“…Therefore, an accurate diagnosis is paramount to timely and correct treatment. Several studies provide information as to the variability of interpretation of radiological examinations, including MRI examinations of the lumbar spine, and the importance of nomenclature when communicating radiological findings [1][2][3][4][5][6][7][8][9][10][11]. However, these studies provide no information as to the variability and quality of interpretation of all MRI findings in a single patient imaged at different imaging centers.…”