Diagnostic Errors in Neuroradiology: A Message to Emergency Radiologists and Trainees

Abstract

Diagnostic errors in neuroradiology are inevitable, yet potentially avoidable. Through extensive literature search, we present an up-to-date review of the psychology of human decision making and how such complex process can lead to radiologic errors. Our focus is on neuroradiology, so we augmented our review with multiple explanatory figures to show how different errors can reflect on real-life clinical practice. We propose a new thematic categorization of perceptual and cognitive biases in this article to simplify message delivery to our target audience: emergency/general radiologists and trainees. Additionally, we highlight individual and organizational remedy strategies to decrease error rate and potential harm.

Know your way around acute unenhanced CT during global iodinated contrast crisis: a refresher to ED radiologists

“…Systematic use of brief, focused checklists or search patterns and matching structured or semi-structured reporting are a recognized tool to limit errors in radiology [ 8 , 9 ]. Checklists have been shown to reduce perceptual errors in critical care medicine and aviation [ 10 ] with promising results in radiology [ 11 ].…”

Diagnostic Errors in Emergency Neuroradiology: Can We Do Better?

“…In this issue, Hussien et al have reviewed types of errors in radiology with a focus on errors in neuroradiology. 2 There are multiple methods to classify diagnostic errors in radiology. One classification scheme 3,4 offers 4 types of errors: 1) Observer errors, 2) errors in interpretation, 3) failure to suggest the next appropriate procedure, and 4) failure to communicate in a timely and clinically appropriate manner.…”

“…In their review, Hussien et al provide an excellent summary of such strategies and point out the need for institution of several methods to reduce diagnostic errors in neuroradiology. 2 Strategies include the use of checklists and structured reporting. In a study of 3000 MRI lumbar spine examinations, structured reporting helped identify clinically significant extraspinal findings in 28.5% of the patients.…”