From the Departments of Radiology and Medical Imaging (S.H.P.)
Department of Radiology (C.L.S., S.G.M., T.M.S.), New York University Langone Medical Center, New York, New York.
AJNR Am J Neuroradiol. 2019 Aug;40(8):1252-1256. doi: 10.3174/ajnr.A6125. Epub 2019 Jul 11.
Diagnostic errors in radiology are classified as perception or interpretation errors. This study determined whether specific conditions differed when perception or interpretation errors occurred during neuroradiology image interpretation.
In a sample of 254 clinical error cases in diagnostic neuroradiology, we classified errors as perception or interpretation errors, then characterized imaging technique, interpreting radiologist's experience, anatomic location of the abnormality, disease etiology, time of day, and day of the week. Interpretation and perception errors were compared with hours worked per shift, cases read per shift, average cases read per shift hour, and the order of case during the shift when the error occurred.
Perception and interpretation errors were 74.8% ( = 190) and 25.2% ( = 64) of errors, respectively. Logistic regression analyses showed that the odds of an interpretation error were 2 times greater (OR, 2.09; 95% CI, 1.05-4.15; = .04) for neuroradiology attending physicians with ≤5 years of experience. Interpretation errors were more likely with MR imaging compared with CT (OR, 2.10; 95% CI, 1.09-4.01; = .03). Infectious/inflammatory/autoimmune diseases were more frequently associated with interpretation errors ( = .04). Perception errors were associated with faster reading rates (6.01 versus 5.03 cases read per hour; = .004) and occurred later during the shift (24th-versus-18th case; = .04).
Among diagnostic neuroradiology error cases, interpretation-versus-perception errors are affected by the neuroradiologist's experience, technique, and the volume and rate of cases read. Recognition of these risk factors may help guide programs for error reduction in clinical neuroradiology services.
放射诊断中的错误可分为感知错误或解释错误。本研究旨在确定在神经影像学图像解释过程中出现感知或解释错误时，是否存在特定的差异。
在 254 例诊断性神经放射学中的临床错误案例样本中，我们将错误分为感知或解释错误，然后对成像技术、解释放射科医生的经验、异常的解剖位置、疾病病因、一天中的时间和一周中的天数进行特征描述。我们将解释和感知错误与每次轮班工作的时间、每次轮班阅读的病例、每次轮班每小时平均阅读的病例以及在轮班期间发生错误的病例顺序进行比较。
感知错误和解释错误分别占错误的 74.8%（=190）和 25.2%（=64）。逻辑回归分析显示，经验≤5 年的神经放射科主治医生发生解释错误的可能性是感知错误的 2 倍（比值比，2.09；95%置信区间，1.05-4.15；=0.04）。与 CT 相比，磁共振成像（MR 成像）更易导致解释错误（比值比，2.10；95%置信区间，1.09-4.01；=0.03）。感染/炎症/自身免疫性疾病与解释错误的相关性更高（=0.04）。感知错误与更快的阅读速度相关（每小时阅读的病例数为 6.01 例与 5.03 例；=0.004），并且更可能在轮班后期发生（第 24 例与第 18 例；=0.04）。
在诊断性神经放射学错误案例中，解释错误与感知错误受放射科医生的经验、技术以及阅读的病例数量和速度的影响。认识到这些风险因素可能有助于指导临床神经放射学服务中的错误减少计划。
