![]() Interestingly, his data showed a progressive reduction in the length of time between the introduction of a new imaging technology and the first filed lawsuit arising from its use, from over 10 years for ultrasound (first suit 1982), to 8 years for CT (first suit 1982), and 4 years for MRI (first suit 1987). Leonard Berlin, writing in 1995, found that the rate of radiology-related malpractice lawsuits in Cook County, Illinois, USA, was rising inexorably, with the majority of suits for missed diagnosis, and we have no reason to believe that this pattern has since changed. Just how frequently will be addressed in another section of this paper. This is not to suggest that radiological error does not occur it does, and frequently. ![]() “Discrepancy” is a better term to describe what happens in many such cases. Many cases of supposed error, in fact, fall within the realm of reasonable differences of opinions between conscientious practitioners. Certainly, in some circumstances, diagnoses are proven by pathologic examination of surgical or autopsy material, and this proof can be used to evaluate prior radiological diagnoses, but this is not a common basis for determining whether error has occurred. Expert opinion often forms the basis for deciding whether an error has been made, but it should be noted that “experts” themselves may also be subject to question ( “An expert is someone who is more than fifty miles from home, has no responsibility for implementing the advice he gives, and shows slides.” - Ed Meese, US Attorney General 1985–88).Īny discrepancy in interpretation that deviates substantially from a consensus of one’s peers is a reasonable and commonly accepted definition of interpretive radiological error, but even this is a loose description of a complex process, and may be subject to debate in individual circumstances. In real life, there is frequently room for legitimate differences of opinion about diagnoses or for “failure” to identify an abnormality that can be seen in retrospect. The use of the term “error” implies that there is no potential for disagreement about what is “correct”, and indicates that the reporting radiologist should have been able to make the correct diagnosis or report, but did not. In this context, defining what constitutes radiological error is not straightforward. Radiological studies do not come with inbuilt labels denoting the most significant abnormalities, and interpreting them is not a binary process (normal vs abnormal, cancer vs “all-clear”). Sometimes it is possible to be definitive in radiological diagnoses, but in most cases, radiological interpretation is heavily influenced by the clinical circumstances of the patient, relevant past history and previous imaging, and myriad other factors, including biases of which we may not be aware. They represent clinical consultations, resulting in opinions which are conclusions arrived at after weighing of evidence “opinion” can be defined as “a view held about a particular subject or point a judgement formed a belief”. ![]() We don’t always get it right.Īlthough not always appreciated by the public, or indeed by referring doctors, radiologists’ reports should not be expected to be definitive or incontrovertible. This activity constitutes much of the daily work of practising radiologists. Most professional bodies would agree that all imaging procedures should include an expert radiologist’s opinion, given by means of a written report. It was recently estimated that one billion radiologic examinations are performed worldwide annually, most of which are interpreted by radiologists.
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