Reviewing Your Own Imaging: Commonly Missed/Misinterpreted Injuries on X-ray

Abstract

Image interpretation represents a critical component of emergency medicine practice, as diagnostic accuracy directly informs clinical management, treatment decisions, and patient disposition. Errors in radiographic interpretation arise from a variety of sources; however, cognitive biases are responsible for approximately 74% of misinterpretations and are strongly associated with adverse patient outcomes. This article highlights three particularly prevalent cognitive biases-satisfaction of search, anchoring, and normalization bias-and illustrates their impact through clinical vignettes. In addition, strategies for bias recognition and mitigation are presented to support diagnostic accuracy and enhance patient safety in the emergency department.

Keywords: Anchoring bias; Cognitive bias; Diagnostic errors; Emergency medicine; Normalization bias; Patient safety; Satisfaction of search.