Malpractice and radiologists, update 1986: an 11.5-year perspective

Berlin, Leonard

doi:10.2214/ajr.147.6.1291

Cited by 41 publications

(8 citation statements)

References 6 publications

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“…In particular, lung cancer lesions have been reported as the most frequently missed lesions leading to such litigation (15)(16)(17)(18). Therefore, in clinical settings, radiologists may hesitate in diagnosing normal cases with confidence.…”

Section: Discussionmentioning

confidence: 99%

Improved Detection of Lung Nodules by Using a Temporal Subtraction Technique

Kakeda¹,

Nakamura²,

Kamada³

et al. 2002

Radiology

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Section: Discussionmentioning

confidence: 99%

Improved Detection of Lung Nodules by Using a Temporal Subtraction Technique

Kakeda¹,

Nakamura²,

Kamada³

et al. 2002

Radiology

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“…This means oversight of abnormalities or misinterpretation of radiologic images [3,7].Errors in diagnostic radiology have long been recognized, beginning with the pioneering revelation of Garland [8] in 1949. Multiple studies have identified suboptimal radiology processes as contributors to the overwhelming number of medical errors and escalating economic costs, which are estimated at more than $38 billion annually [9, 10].…”

mentioning

confidence: 99%

Cognitive and System Factors Contributing to Diagnostic Errors in Radiology

Lee

Nagy

Weaver

et al. 2013

American Journal of Roentgenology

287

210

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Every radiologist worries about missing a diagnosis or giving a false-positive reading. The retrospective error rate among radiologic examinations is approximately 30%, with real-time errors in daily radiology practice averaging 3-5%. Nearly 75% of all medical malpractice claims against radiologists are related to diagnostic errors. As medical reimbursement trends downward, radiologists attempt to compensate by undertaking additional responsibilities to increase productivity. The increased workload, rising quality expectations, cognitive biases, and poor system factors all contribute to diagnostic errors in radiology. Diagnostic errors are underrecognized and underappreciated in radiology practice. This is due to the inability to obtain reliable national estimates of the impact, the difficulty in evaluating effectiveness of potential interventions, and the poor response to systemwide solutions. Most of our clinical work is executed through type 1 processes to minimize cost, anxiety, and delay; however, type 1 processes are also vulnerable to errors. Instead of trying to completely eliminate cognitive shortcuts that serve us well most of the time, becoming aware of common biases and using metacognitive strategies to mitigate the effects have the potential to create sustainable improvement in diagnostic errors.

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“…This is in stark contrast to a survey two decades later that identified an emerging malpractice allegation: lawsuits alleging patient injury resulting from the referring physician's failure to order radiologic studies [6]. From the early 1970s to the late 1980s, the number of lawsuits alleging failure to diagnose cancer increased 50% [7]. An American College of Radiology (ACR) Bulletin article in 1985 disclosed that missed fractures or dislocations were the leading cause of radiologic lawsuits in the US, but claims of failure to diagnose cancer were second in frequency [8].…”

Section: Medical Negligence Evolves From Errors Of Commission To Erromentioning

confidence: 73%

Medical errors, malpractice, and defensive medicine: an ill-fated triad

Berlin

2017

Diagnosis

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For the first 180 years following the founding of the US, physicians occasionally were sued for medical malpractice. Allegations of negligence were errors of commission -i.e. the physician made a mistake by doing something wrong, usually mistreatment of a fracture or dislocation, a complication or death following a surgical procedure, prescribing the wrong medication, and after the discovery of the X-ray by Roentgen in 1895, causing radiation burns. In the mid twentieth century malpractice allegations slowly changed from errors of commission to errors of omission -i.e. the physician failed to do something right: almost always, failed to make a diagnosis. The number of malpractice lawsuits increased at a geometric rate beginning in the 1960s, and in the 1970s physicians began practicing defensive medicine, which lead physicians to order unnecessary radiology exams and tests. In the past 20 years the number of malpractice lawsuits has been decreasing, but the practice of defensive medicine has continued. Unnecessary exams and tests increase the likelihood of overdiagnosis and overtreatment, i.e. a new kind of error of commission.

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Malpractice and radiologists, update 1986: an 11.5-year perspective

Cited by 41 publications

References 6 publications

Improved Detection of Lung Nodules by Using a Temporal Subtraction Technique

Improved Detection of Lung Nodules by Using a Temporal Subtraction Technique

Cognitive and System Factors Contributing to Diagnostic Errors in Radiology

Medical errors, malpractice, and defensive medicine: an ill-fated triad

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