One-third of delayed diagnoses not recognized on subsequent exams

Tuesday, November 30 | 11:30 a.m.-11:40 a.m. | SSG07-07 | Room S102D
Delayed diagnoses in radiology are often not recognized on subsequent radiological examinations, due to multiple types of diagnostic errors, according to researchers from Brooke Army Medical Center in San Antonio and Tripler Army Medical Center in Honolulu.

Liem Mansfield, MD, and colleague Young Kim, MD, will present findings from a study they conducted that included 656 radiological exams with delayed diagnoses collected from July 2002 to January 2010. The team collected data such as the number of days elapsed between the initial exam on which the diagnosis was missed and the subsequent exam on which the correct diagnosis was made, the imaging technique with which the diagnosis was missed, the imaging technique with which the correct diagnosis was made, and whether the diagnosis was missed on subsequent radiologic exams.

Mansfield and Kim found a total of 1,279 errors; diagnoses were not recognized on subsequent radiological exams in 30% of the cases, or 196.

The diagnosis was initially missed with the following imaging techniques:

  • Radiography: 354 (54%)
  • CT: 200 (31%)
  • MR: 75 (11%)
  • Nuclear medicine: 18 (3%)
  • Ultrasound: 9 (1%)

The diagnosis was subsequently missed with the following imaging techniques:

  • Radiography: 118 (60%)
  • CT: 46 (23%)
  • MR: 17 (9%)
  • Nuclear medicine: 13 (7%)
  • Ultrasound: 2 (1%)

Nearly a third of delayed diagnoses in radiology weren't found on subsequent exams, Mansfield and Young concluded. They attributed this statistic to errors such as under-reading, satisfaction of search (in which the detection of one radiographic finding interferes with that of others), faulty reasoning, and location.

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