Unfortunately, radiology diagnostic errors are surprisingly high, which can lead to patient harm. Radiologists play a crucial role in the diagnostic process, but you likely will never even learn the name of the radiologist working on your case.
You, and your doctor, put enormous trust in the pathologist’s opinion. But what if the radiologist makes a mistake and misses your diagnosis of cancer or another serious illness? Your condition may worsen for weeks or months until you get a correct diagnosis. Conversely, the opposite scenario could happen – you are diagnosed with a disease, and potentially even treated for a disease, that you don’t have.
How common are radiology diagnostic errors?
The error rate for radiology diagnoses is estimated to be between 10-15%, a rate similar to that of 1960. Furthermore, a 2001 review found the rate of clinically significant errors in radiology was between 2-20%.
How many patients can this impact? There are approximately 1 billion radiologic imaging examinations performed worldwide every year, and most of the resulting images are interpreted by radiologists. If the error rate is only 4%, it translates to 40 million radiology errors every year in the world.
Certainly, a concern for patients every where.
Interestingly, a recent study evaluated second readings performed by experienced abdominal imaging radiologists. The radiologists disagreed with each other more than 30% of the time and disagreed with themselves more than 25% of the time!
What kinds of errors do radiologists make?
Radiology diagnostic errors fall into one (or more) of the following four categories:
1. Technique or image acquisition errors
Radiologist can make mistakes due to the technical or physical limitations of the imaging modality. Staff shortages, staff inexperience and inadequate equipment are often the cause of errors.
2. Perceptual errors
When radiologists fail to identify an abnormality.
3. Cognitive and/or interpretative errors
Radiologists may see an abnormality or a normal variant, but they misunderstand its meaning or importance, resulting in an incorrect diagnosis.
4. Communication errors
When radiologists fail to effectively communicate the results, patients can suffer harm. For example, radiologists may make incorrect recommendations, or may miscommunicate important findings.
Why do radiologists make errors?
Making a radiologic diagnosis is a very complex process that takes much more time than just taking the images. A variety of factors can impact the diagnostic process, including work environment and workplace distractions, the volume of imaging studies, pressure for fast results, limited patient information.
A 2016 review of 182 cases revealed that the most common reasons for radiologic diagnostic errors were:
- Failure to consult prior studies or reports.
- Limitations in imaging technique.
- Having an inaccurate or incomplete history.
- Location of the abnormality outside of the region that was studied.
- Failure to search systematically beyond the first abnormality discovered.
- Failure to recognize a normal variant.
What can you do to reduce your risk of radiology diagnostic errors?
Because a diagnostic error can have devastating consequences, it is important to reduce your risk of this happening to you. I suggest the following:
- Speak with your doctor once the results have come in to be sure the results are consistent with your symptoms.
- If you are worried that your results are not accurate, you can ask your doctor to order a repeat of imaging or a simple test; for a more expensive and/or more invasive test or imaging, ask your doctor to have your results evaluated by another radiologist.
To reduce your risk of a diagnostic error, read these blog posts:
- 10 Steps to Reduce Your Risk of Diagnostic Error.
- Why are Second Opinions Important?
- 10 Tips for a Better Medical Appointment.
- 10 Tips to Communicate Better with Doctors.
- How Can You Get the Best Healthcare? Actively Participate!
- Understanding Medical Information Is Harder Than Most Realize.
- The Dangers of Too Many Medical Tests and Treatments.
- The Importance of Shared Decision Making.
NOTE: I updated this post on March 13, 2018.
D Johnson says
Thank you for writing this. I was diagnosed with relapsing remitting multiple sclerosis 23 years ago and unfortunately had to stop working in 2015, a few years after progressing to SPMS.
The latest radiologist to examine my MRI has decided I suddenly have no evidence of a demyelenating disease. If this were true and I were cured and could walk, I’d be thrilled!
Instead, he has thrown a giant kink in my life.