Page 17 - Diagnostic Radiology - Interpreting the Risks Part Two_Neat

SVMIC Diagnostic Radiology: Interpreting the Risks

Rapid film interpretation speed can obviously be a source

of error. The accuracy in lung cancer detection decreases
significantly with viewing times of less than four seconds

according to one study. When radiologists were asked to
3
interpret studies at twice their baseline speed, the number

of major misses increased from 10 percent to 26.6 percent. A
sustained artificially high interpretive rate can result in additional

interpretive errors from both general and oculomotor fatigue.
See the following case example.

CASE STUDY

A 15-year-old male suffered a head injury and presented to
the emergency department via ambulance with complaints

of head and neck pain. CTs of the head and neck were
performed which the radiologist read as normal. Patient

was discharged. Approximately three hours later, the patient
returned with confusion, aggressive behavior, vomiting,

and worsening headache. He experienced a seizure while
waiting to have a second CT performed. The second CT

revealed a fractured skull, epidural hematoma, and brain
herniation. After suffering a second seizure, the patient was

comatose for two months. He has devastating neurologic
injuries and flaccid left side. He lost some vision in both

eyes and has no control of bowel and bladder functions. He
cannot perform the tasks of daily living.

The findings on the first CT were subtle. Experts disagreed
as to whether missing these findings was a deviation from

the standard of care. Our very experienced defense expert

continued on next page

3 “Interpretive Error in Radiology,” AJR:208, April 2017

Page 17