Interpretive Error in Radiology

AJR Am J Roentgenol. 2017 Apr;208(4):739-749. doi: 10.2214/AJR.16.16963. Epub 2016 Dec 27.


Objective: Although imaging technology has advanced significantly since the work of Garland in 1949, interpretive error rates remain unchanged. In addition to patient harm, interpretive errors are a major cause of litigation and distress to radiologists. In this article, we discuss the mechanics involved in searching an image, categorize omission errors, and discuss factors influencing diagnostic accuracy. Potential individual- and system-based solutions to mitigate or eliminate errors are also discussed.

Conclusion: Radiologists use visual detection, pattern recognition, memory, and cognitive reasoning to synthesize final interpretations of radiologic studies. This synthesis is performed in an environment in which there are numerous extrinsic distractors, increasing workloads and fatigue. Given the ultimately human task of perception, some degree of error is likely inevitable even with experienced observers. However, an understanding of the causes of interpretive errors can help in the development of tools to mitigate errors and improve patient safety.

Keywords: bias; computer-aided detection (CAD); error; fatigue; malpractice; perception; workload.

Publication types

  • Review

MeSH terms

  • Diagnostic Errors / prevention & control*
  • Diagnostic Imaging / methods*
  • Humans
  • Observer Variation
  • Patient Safety
  • Reproducibility of Results
  • Sensitivity and Specificity
  • United States
  • Visual Perception*