Common, but litigious errors in radiology reports, that can be avoided and strategies to minimize them:-
To err is human and you can only minimize it
1. Right vs left errors
2. Missing or inadvertent inclusion of "No"
3. Scan received with wrong demographics (wrong fixing of patient details on a scan of different patient). This usually happens at the level of technician. It can be very difficult to detect; expect, when you find a mismatch between the history and scan finding.
4. Reporting scan of a different patient on some other, when more that 1 study is open in PACS
5. Wrong measurements: "mm" becomes "cm" or the "point" between is missing (1.1 cm vs 11 cm)
6. Describing an organ normal; though, have been removed for eg. writing normal gallbladder in a case of cholecystectomy.
7. Short forms going wrong, especially with dictation eg. VUJ vs PUJ
8. Same short forms may have multiple expansions eg.
CVA- cardiovascular anomaly
CVA: Cerebrovascular Accident
8. Calling hypovascular or treated liver mets as cyst on CT scan
9. Missing a renal or ureteric calculus / calculi
10. Using ROMAN numerals: Error can happen II vs III / IV vs V vs VI. You miss or misplace the vertical line.
Strategies:
Not necessarily apply to all work practice
1. There is no short cut and all reports need to be checked once again after they are printed and ready for dispatch. For complete digital workflow, 2nd read.
2. Can highlight the left and right in the report (this can be checked by search function in MS word). word can also do the grammar check. Another option is to use "grammarly"
3. Stick to one measurement style either in mm or cm. Avoid measurements with "point". Good idea to round off to the nearest value
4. Before starting the dictation check the demographic match on the RIS and the pacs.
5. Interruption between dictation: If you have an urgent review, close the report and images of the ongoing dictation, as there is a chance, you may dictate the newly opened images on previous report. After every interruption, it i a good idea to check the name.
6. One of the strategy could be to finish all dictations and do report correction later once all studies are reported. This way you also have a relook at the scan.
7. "Zero Error" detection of KUB calculus: Visualization of the KUB region by using thin MIP in both axial and coronal planes
8. Providing a key image in the report can cover up for errors in location and size. Once author gave wrong measurement of a 3 cm HCC, fortunately a key image was pasted on the report and error was detected.
9. Developing a good rapport with your clinical colleagues can add as a 2nd line of defense. The can always call if, they pick an error.
10. Always start report after checking 3 vital information:
- Demographics
- Previous scans / lab reports
- Previous surgery: Announcing post op- status at the start of report can be helpful
11. Use of AI
12. Using English numeral instead of roman numeral can eliminate errors (like II vs III or IV vs V)
13. Impression:How concise is an individual choice. Make sure there is no discrepancy with body of report, as 80 % physicians to do not read body of report.
TAKE HOME POINT: MOST IMPORTANT IS TO HAVE TWO WAY COMMUNICATION WITH THE REFERRING PHYSICIAN
Created by Dr. Sharad Maheshwari and inputs received from colleagues
Published: 3.10.2022
Updated: 10.10.2022
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