Page 14 - Diagnostic Radiology - Interpreting the Risks Part Two_Neat

SVMIC Diagnostic Radiology: Interpreting the Risks

Two broad categories of radiologic error have been identified:

perceptual errors and cognitive errors. These are also known as
“observer variation” and “interpretive error”.

Perceptual errors are much more common, accounting for 60-80

percent of radiologists’ errors. Perceptual errors occur during
1
the initial detection phase of the image interpretation. Because

the first step in image interpretation is detection, an error in
perception can prematurely end the diagnostic process and lead

to misdiagnoses. In general, to be considered a perceptual error,
the finding would need to be deemed sufficiently conspicuous

and detectable in retrospect by the interpreting radiologist or by
a consensus of his or her peers.

Cognitive or interpretive errors occur when an abnormality
is identified on an image, but its importance is incorrectly

understood, resulting in an incorrect final diagnosis. This type
of error may be secondary to a lack of knowledge, a cognitive

bias on the part of the radiologist interpreting the study, or
misleading clinical information distorting the apparent pretest

probability of disease; it could also simply be a result of a
radiologist inadvertently propagating an error made by a

colleague in the previous radiology report (sometimes termed
alliterative error or satisfaction of report). An in-depth analysis

of the various causes of all perceptual and cognitive errors are
beyond the scope of this course. However, the primary factors

identified by experts as causes of interpretive error are as
follows:

• The intrinsic characteristics of lesions

• Scene processing

1 Waite et al., “Interpretive Error in Radiology,” AJR:208, April, 2017.

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