Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. As the number of malpractice cases continues to grow, radiologists will become increasingly involved in litigation. The aetiology of radiological error is multi-factorial. This book focuses on (1) some medico-legal aspects inherent to radiology (radiation exposure related to imaging procedures and malpractice issues related to contrast media administration are discussed in detail) and on (2) the spectrum of diagnostic errors in radiology. Communication issues between the radiologists and physicians and between the radiologists and patients are also presented. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation.
This book describes and illustrates the gamut of errors that may arise during the performance and interpretation of imaging of both nontraumatic and traumatic emergencies, using a head-to-toe approach. The coverage encompasses mistakes related to suboptimal imaging protocols, failure to review a portion of the examination, satisfaction of search error, and misinterpretation of imaging findings. The book opens with an overview of an evidence-based approach to errors in imaging interpretation in patients in the emergency setting. Subsequent chapters describe errors in radiographic, US, multidetector CT, dual-energy CT, and MR imaging of common as well as less common acute conditions, including disorders in the pediatric population, and the unique mistakes in the imaging evaluation of pregnant patients. The book is written by a group of leading North American and European Emergency and Trauma Radiology experts. It will be of value to emergency and general radiologists, to emergency department physicians and related personnel, to general and trauma surgeons, and to trainees in all of these specialties.
Over the past decade, radiological imaging tests - including CT scanning, MRI, PET, X-rays, ultrasound, fluoroscopy and other modalities - have become essential to the routine diagnostic process. While these modern advanced medical images and their striking anatomic detail have discovered underlying issues, they have also contributed to a false impression of infallibility. Unlike other straightforward diagnostic tests, such as the EKG or blood chemistry panel, radiological imaging tests are highly variable and complex, often yielding uncertain results, as well as frequent false-negatives and false-positives. The experts who interpret the images (the diagnostic radiologists) sometimes make mistakes: the practice of diagnostic radiology is a fallible, human endeavour, one involving complex perceptual, neuro-physiological and cognitive processes employed under a wide range of circumstances, and with a great deal of variability. Error and Uncertainty in Diagnostic Radiology opens the 'black box,' of medical imaging, exposing the remarkable inner workings of the process of diagnostic radiology-including how and why it can sometimes go tragically wrong. The occurrence of radiological error is shown to be fundamentally intertwined with the underlying high level of uncertainty known to be present in the diagnostic process. As a foremost expert on radiology quality and safety, Dr. Bruno provides insight into the various types of radiologist error, along with a conceptual framework for understanding error and uncertainty in radiology, leading to practical strategies for error prevention and for reducing the risk of harm to patients when errors inevitably occur. This book is essential for radiologists, members of the Society to Improve Diagnosis in Medicine, emergency physicians, medical educators, medical and hospice administrators, especially quality and safety officers, as well as malpractice insurance carriers.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
In Avoiding Errors in Radiology: Case-Based Analysis of Causes and PreventiveStrategies, the authors provide 118 real-life examples of interpretation errorsand wrong decisions from both diagnostic and interventional radiology. Ineach case, the authors discuss in detail the context in which the errors weremade, the resulting complications, and strategies for future prevention. Thecases are organized by body region, beginning with the cranium and thenmoving to cases of the breast, chest and abdomen, spinal column, musculoskeletaland vascular systems.Features: 118 case studies facilitate analysis and discussion of causes of errors andoffer preventive strategies to transfer into daily practice 956 high-quality images and explanatory drawings illustrate the cases andpinpoint errors of interpretation and in decision making Avoiding Errors in Radiology is a must-have reference for anyone involved ininterpreting images for diagnosis and in making decisions in interventionalradiology.It will provide a useful textbook for radiologists to browse through and we will all hopefully learn from their mistakes as well as the ones we make.--RAD Magazine
This superbly illustrated book offers comprehensive and systematic coverage of the pitfalls that may arise during musculoskeletal imaging, whether as a consequence of the imaging technique itself or due to anatomical variants or particular aspects of disease. The first section is devoted to technique-specific artifacts encountered when using different imaging modalities and covers the entire range of advanced methods, including high-resolution ultrasonography, computed tomography, magnetic resonance imaging and positron emission tomography. Advice is provided on correct imaging technique. In the second section, pitfalls in imaging interpretation that may occur during the imaging of trauma to various structures and of the diseases affecting these structures are described. Misleading imaging appearances in such pathologies as inflammatory arthritides, infections, metabolic bone lesions, congenital skeletal dysplasis, tumors and tumor-like conditions are highlighted, and normal variants are also identified. Pitfalls in Musculoskeletal Radiology will be an invaluable source of information for the practicing radiologist, facilitating recognition of pitfalls of all types and avoidance of diagnostic errors and misinterpretations, with their medicolegal implications.
A state-of-the-art review of key topics in medical image perception science and practice, including associated techniques, illustrations and examples. This second edition contains extensive updates and substantial new content. Written by key figures in the field, it covers a wide range of topics including signal detection, image interpretation and advanced image analysis (e.g. deep learning) techniques for interpretive and computational perception. It provides an overview of the key techniques of medical image perception and observer performance research, and includes examples and applications across clinical disciplines including radiology, pathology and oncology. A final chapter discusses the future prospects of medical image perception and assesses upcoming challenges and possibilities, enabling readers to identify new areas for research. Written for both newcomers to the field and experienced researchers and clinicians, this book provides a comprehensive reference for those interested in medical image perception as means to advance knowledge and improve human health.
The practice of diagnostic radiology has become increasingly complex, with the use of numerous imaging modalities and division into many subspecialty areas. It is becoming ever more difficult for subspecialist radiologists, general radiologists, and residents to keep up with the advances that are occurring year on year, and this is particularly true for less familiar topics. Failure to appreciate imaging pitfalls often leads to diagnostic error and misinterpretation, and potential medicolegal problems. This textbook, written by experts from reputable centers across the world, systematically and comprehensively highlights the pitfalls that may occur in diagnostic radiology. Both pitfalls specific to different modalities and techniques and those specific to particular organ systems are described with the help of numerous high-quality illustrations. Recognition of these pitfalls is crucial in helping the practicing radiologist to achieve a more accurate diagnosis.
This book gets to the heart of what radiology is and what radiologists do. As a relatively young speciality, there is no guide for radiologists to act as a moral compass. Until now, that is. You will not find any dry technical matters in here. You will not find any clues about how to interpret images better. This book details the ‘other 50%’: the rest of the working week when a radiologist is not reading scans or performing procedures. The essence of radiology is distilled and offered up to the reader. If you want a comfortable read that offers bland reassurances, look elsewhere. If you want a book that questions everything and discusses uncomfortable truths, this is the book for you. Each of the Rules addresses an important part of professional practice. This book is a manifesto for all radiologists across the globe to raise their game, to be more effective and to serve their patients better.
