Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(02): 333-344
DOI: 10.1055/s-0041-1734351
Original Article

Radiology Reporting Errors: Learning from Report Addenda

Anurima Patra
1   Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
,
Manthreshwar Premkumar
1   Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
,
Shyamkumar N. Keshava
1   Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
,
Anuradha Chandramohan
1   Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
,
Elizabeth Joseph
1   Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
,
Sridhar Gibikote
1   Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Background The addition of new information to a completed radiology report in the form of an “addendum” conveys a variety of information, ranging from less significant typographical errors to serious omissions and misinterpretations. Understanding the reasons for errors and their clinical implications will lead to better clinical governance and radiology practice.

Aims This article assesses the common reasons which lead to addenda generation to completed reports and their clinical implications.

Subjects and Methods Retrospective study was conducted by reviewing addenda to computed tomography (CT), ultrasound, and magnetic resonance imaging reports between January 2018 to June 2018, to note the frequency and classification of report addenda.

Results Rate of addenda generation was 1.1% (n = 1,076) among the 97,003 approved cross-sectional radiology reports. Errors contributed to 71.2% (n = 767) of addenda, most commonly communication (29.3%, n = 316) and observational errors (20.8%, n = 224), and 28.7% were nonerrors aimed at providing additional clinically relevant information. Majority of the addenda (82.3%, n = 886) did not have a significant clinical impact. CT and ultrasound reports accounted for 36.9% (n = 398) and 35.2% (n = 379) share, respectively. A time gap of 1 to 7 days was noted for 46.8% (n = 504) addenda and 37.6% (n = 405) were issued in less than a day. Radiologists with more than 6-year experience created majority (1.5%, n = 456) of addenda. Those which were added to reports generated during emergency hours contributed to 23.2% (n = 250) of the addenda.

Conclusion The study has identified the prevalence of report addenda in a radiology practice involving picture archiving and communication system in a tertiary care center in India. The etiology included both errors and non-errors. Results of this audit were used to generate a checklist and put protocols that will help decrease serious radiology misses and common errors.

Keywords

addenda - diagnostic error rate - misinterpretation - radiological discrepancy


Publication History

Article published online:
12 August 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Baccei SJ, Hoimes M, Shin H, Karam AR. Reducing radiology report addenda using provisionally signed status. J Am Coll Radiol 2015; 12 (01) 108-110
    CrossrefPubMedGoogle Scholar
  • 2 Berlin L, Berlin JW. Malpractice and radiologists in Cook County, IL: trends in 20 years of litigation. AJR Am J Roentgenol 1995; 165 (04) 781-788
    CrossrefPubMedGoogle Scholar
  • 3 Pinto A, Brunese L. Spectrum of diagnostic errors in radiology. World J Radiol 2010; 2 (10) 377-383
    CrossrefPubMedGoogle Scholar
  • 4 Lauritzen PM, Andersen JG, Stokke MV. et al. Radiologist-initiated double reading of abdominal CT: retrospective analysis of the clinical importance of changes to radiology reports. BMJ Qual Saf 2016; 25 (08) 595-603
    CrossrefPubMedGoogle Scholar
  • 5 Romano L, Pinto A. eds. Errors in Radiology. Milano:. Springer Milan 2012; 2-5
    Google Scholar
  • 6 Reiner BI. The challenges, opportunities, and imperative of structured reporting in medical imaging. J Digit Imaging 2009; 22 (06) 562-568
    CrossrefPubMedGoogle Scholar
  • 7 Pinto A, Caranci F, Romano L, Carrafiello G, Fonio P, Brunese L. Learning from errors in radiology: a comprehensive review. Semin Ultrasound CT MR 2012; 33 (04) 379-382
    CrossrefPubMedGoogle Scholar
  • 8 Brigham LR, Mansouri M, Abujudeh HH. Journal club: radiology report addenda: a self-report approach to error identification, quantification, and classification. AJR Am J Roentgenol 2015; 205 (06) 1230-1239
    CrossrefPubMedGoogle Scholar
  • 9 Balthazar P, Konstantopoulos C, Wick CA. et al. Trainees may add value to patient care by decreasing addendum utilization in radiology reports. AJR Am J Roentgenol 2017; 209 (05) 976-981
    CrossrefPubMedGoogle Scholar
  • 10 Hussain S, Allende MB, Karam AR, Hussain JS, Vijayaraghavan G. Addenda to the radiology report: what are we trying to convey?. J Am Coll Radiol 2011; 8 (10) 703-705
    CrossrefPubMedGoogle Scholar
  • 11 Abujudeh HH, Boland GW, Kaewlai R. et al. Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists. Eur Radiol 2010; 20 (08) 1952-1957
    CrossrefPubMedGoogle Scholar
  • 12 Briggs RH, Rowbotham E, Johnstone AL, Chalmers AG. Provisional reporting of polytrauma CT by on-call radiology registrars. Is it safe?. Clin Radiol 2010; 65 (08) 616-622
    CrossrefPubMedGoogle Scholar
  • 13 Ruchman RB, Jaeger J, Wiggins EF II. et al. Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital. AJR Am J Roentgenol 2007; 189 (03) 523-526
    CrossrefPubMedGoogle Scholar
  • 14 Briggs GM, Flynn PA, Worthington M, Rennie I, McKinstry CS. The role of specialist neuroradiology second opinion reporting: is there added value?. Clin Radiol 2008; 63 (07) 791-795
    CrossrefPubMedGoogle Scholar
  • 15 Soffa DJ, Lewis RS, Sunshine JH, Bhargavan M. Disagreement in interpretation: a method for the development of benchmarks for quality assurance in imaging. J Am Coll Radiol 2004; 1 (03) 212-217
    CrossrefPubMedGoogle Scholar
  • 16 Gollub MJ, Panicek DM, Bach AM, Penalver A, Castellino RA. Clinical importance of reinterpretation of body CT scans obtained elsewhere in patients referred for care at a tertiary cancer center. Radiology 1999; 210 (01) 109-112
    CrossrefPubMedGoogle Scholar
  • 17 Strickland NH. Quality assurance in radiology: peer review and peer feedback. Clin Radiol 2015; 70 (11) 1158-1164
    CrossrefPubMedGoogle Scholar
  • 18 Melvin C, Bodley R, Booth A, Meagher T, Record C, Savage P. Managing errors in radiology: a working model. Clin Radiol 2004; 59 (09) 841-845
    CrossrefPubMedGoogle Scholar
  • 19 Chung JH, Strigel RM, Chew AR, Albrecht E, Gunn ML. Overnight resident interpretation of torso CT at a level 1 trauma center an analysis and review of the literature. Acad Radiol 2009; 16 (09) 1155-1160
    CrossrefPubMedGoogle Scholar
  • 20 Borgstede JP, Lewis RS, Bhargavan M, Sunshine JH. RADPEER quality assurance program: a multifacility study of interpretive disagreement rates. J Am Coll Radiol 2004; 1 (01) 59-65
    CrossrefPubMedGoogle Scholar
  • 21 Renfrew DL, Franken Jr EA, Berbaum KS, Weigelt FH, Abu-Yousef MM. Error in radiology: classification and lessons in 182 cases presented at a problem case conference. Radiology 1992; 183 (01) 145-150
    CrossrefPubMedGoogle Scholar
  • 22 Kim YW, Mansfield LT. Fool me twice: delayed diagnoses in radiology with emphasis on perpetuated errors. AJR Am J Roentgenol 2014; 202 (03) 465-470
    CrossrefPubMedGoogle Scholar
  • 23 Jackson VP, Cushing T, Abujudeh HH. et al. RADPEER scoring white paper. J Am Coll Radiol 2009; 6 (01) 21-25
    CrossrefPubMedGoogle Scholar
  • 24 Mohan C. Quality program in radiology: persue or perish. Indian J Radiol Imaging 2017; 27 (01) 1-3
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Donald JJ, Barnard SA. Common patterns in 558 diagnostic radiology errors. J Med Imaging Radiat Oncol 2012; 56 (02) 173-178
    CrossrefPubMedGoogle Scholar
  • 26 Brady AP. Error and discrepancy in radiology: inevitable or avoidable?. Insights Imaging 2017; 8 (01) 171-182
    CrossrefPubMedGoogle Scholar
  • 27 Wilcox JR. The written radiology report. Appl Radiol 2006; 35: 33-37
    CrossrefGoogle Scholar
  • 28 Cleopas A, Villaveces A, Charvet A, Bovier PA, Kolly V, Perneger TV. Patient assessments of a hypothetical medical error: effects of health outcome, disclosure, and staff responsiveness. Qual Saf Health Care 2006; 15 (02) 136-141
    CrossrefPubMedGoogle Scholar
  • 29 Maskell G. Error in radiology-where are we now?. Br J Radiol 2019; 92 (1095) 2018-0845
    CrossrefPubMedGoogle Scholar
  • 30 Zaidi Z. Accreditation standards for medical imaging services. Indian J Radiol Imaging 2010; 20 (02) 89-91
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Minn MJ, Zandieh AR, Filice RW. Improving radiology report quality by rapidly notifying radiologist of report errors. J Digit Imaging 2015; 28 (04) 492-498
    CrossrefPubMedGoogle Scholar
  • 32 Shiraishi J, Li Q, Appelbaum D, Doi K. Computer-aided diagnosis and artificial intelligence in clinical imaging. Semin Nucl Med 2011; 41 (06) 449-462
    CrossrefPubMedGoogle Scholar
  • 33 Robinson PJ, Wilson D, Coral A, Murphy A, Verow P. Variation between experienced observers in the interpretation of accident and emergency radiographs. Br J Radiol 1999; 72 (856) 323-330
    CrossrefPubMedGoogle Scholar