Studies show that radiologists misinterpret or miss findings altogether on 3 to 5% of radiology images every day. That means that radiologists are reaching the wrong or incomplete conclusion 40 million times every year. Let that sink in.
What is the Role of a Radiologist?
Radiology is the medical specialty in the use of imaging technology. This includes X-rays, MRIs, and CT scans, which are employed to diagnose medical conditions. Physicians frequently use radiology to:
- Identify injuries like broken bones, strained muscles, ruptured tendons, and soft tissue damage;
- Discover tumors, arthritis, osteoporosis, pneumonia, and other infections; and
- Monitor the effectiveness of cancer treatment.
A radiologist specializes in diagnosing and treating conditions using imaging equipment. This includes:
- Computed tomography (CT) or computerized axial tomography (CAT);
- Fluoroscopy;
- X-rays;
- Positron emission tomography (PET);
- Fusion imaging (a technique that fuses two different imaging tests);
- Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA);
- Mammography; and
- Nuclear medicine imaging.
There are three main types of radiology: (i) diagnostic radiology; (ii) interventional radiology; and (iii) radiation oncology. There are radiologists who specialize in distinct areas of radiology, such as pediatric radiology, oncology radiology, or interventional radiology.
Radiologists examine every portion of every image when reviewing a radiology study. They must find and report all abnormal findings—even when their findings aren’t related to the reason the treating physician ordered the exam. These are called “incidental” findings or “incidentalomas.”
What are the Causes of Mistakes by Radiologists?
Radiology is a medical specialty that has its share of medical negligence. Diagnostic radiology involves the detection of abnormalities in an imaging examination and an accurate diagnosis. Frequently, a patient’s claim against a radiologist will pertain to a failure to diagnose. Errors in radiology stem from poor technique, failure of perception, a lack of knowledge, and misjudgment. Oversight of abnormalities or misinterpretation of radiologic images make up roughly half of radiology-related medical malpractice cases.
Common errors usually fit into two categories: missed fractures and missed diagnosis of cancer. The most commonly missed fractures are those in the femur, the navicular bone, and the cervical spine. Failure to diagnose cancer frequently involves a lack of appreciation of colorectal carcinoma on barium enema studies, lung nodules on chest radiographs, breast lesions on mammograms, and bone tumors.
Radiologists can sometimes misinterpret images and potentially overlook critical findings. Specifically, medical errors in radiology can stem from issues in perception by the radiologist, which may be related to cognitive factors that influence how radiologists process the images before them and make decisions about their findings. For example, experienced radiologists may instinctively rely on certain methods they learned during their training and develop over time to interpret radiology exams more quickly and efficiently. This is called “heuristics,” which enable a less analytical and more intuitive form of thinking that experts describe as “fast thinking”.
Radiologists are susceptible to cognitive bias, which create a trap for the perception of the radiologist and increase the risk of error. Examples of cognitive bias in radiology include:
- Confirmation bias, which is a mistake in thinking that happens when a radiologist arrives at an initial diagnosis but limits the rest of his or her review to looking for findings that confirm that diagnosis. The radiologist doesn’t look for aspects of a study that would support alternative diagnoses.
- Anchoring bias, is when a radiologist refuses to change his or her initial diagnosis, despite data that suggests a contrary diagnosis.
- Satisfaction of search is when a radiologist locates an initial abnormality, and as a result of this, stops their examination and overlooks other important abnormalities
In addition, there may be systemic factors that can affect the accuracy of a radiologist’s work. Hospitals and practice groups often have demanding productivity measures for radiologists. Plus, long shifts and the high volume of complex work can result in visual and mental fatigue. In fact, a study examining more than 4,200 discrepancies between preliminary and final interpretations of radiology studies showed diagnostic errors were more likely to happen when there are heavier caseloads and longer shifts.
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Radiology is an important tool in modern medicine. These X-rays, CT scans, and MRIs assist in the diagnosis of injuries and diseases; but radiology errors can cause patients to suffer serious harm, often leading to medical malpractice claims. If you believe you’ve been harmed by a radiology mistake in your care as a patient, you should speak with an experienced Michigan medical malpractice attorney at Buchanan Firm.
Our firm proudly serves people all across Michigan, including major cities like Grand Rapids, Muskegon, Detroit, Lansing, Holland, St. Joe, and Ann Arbor, and rural towns such as Lowell, Ada, Fremont, Newaygo, Grand Haven, Rockford, and Cedar Springs. We will meet you after hours, at home, or in the hospital to accommodate you.
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