Page 18 - Diagnostic Radiology - Interpreting the Risks Part Two_Neat

SVMIC Diagnostic Radiology: Interpreting the Risks

CASE STUDY

continued
on a blind reading, given no information except a history

of head trauma and neck pain, did not see the fracture or
the hematoma. After being shown the second CT, however,

he had no difficulty finding the fracture and hematoma. In
hindsight, the injuries were “very obvious”. As our expert

said, “This is a tough one, because we are supposed to see
this, even though obviously he (and I) did not without seeing

the second CT,” concluding, “maybe, I went too fast.”

The jury apparently did not lack the clarity of
the two radiologists. The plaintiff was awarded

a multi-million dollar verdict.

Distractions are also a major contributing factor to diagnostic
errors. Radiologists spend a significant amount of time toggling

between medical tasks such as examination interpretation,

consulting with referring physicians, and nonmedical functions
such as answering telephone calls and returning pages. Other
4
interruptions unrelated to the case may include responding

to texts or emails and “surfing the net”. Multi-tasking also has

the potential to introduce errors. Correlating the number of
telephone calls received by an overnight on-call resident with
resident-attending discordant interpretations, it was found

in one study that in the one hour preceding a discordant

preliminary report, a single additional telephone call above
the baseline increased the odds of a major discrepancy by 12

4 Balint BJ, Steenburg SD, Lin H, Shen C, Steele JL, Gunderman RB. “Do telephone call interruptions
have an impact on radiology resident diagnostic accuracy?” Acad Radiol 2014; 21:1623–1628

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