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Radiological errors in the Canadian Journal of Emergency Medicine
Insights
Radiologic image accuracy in the Canadian Journal of Emergency Medicine (CJEM) was evaluated. While generally high quality, 24% of images had errors, with radiologist involvement potentially improving accuracy.
Area of Science:
- Medical Imaging
- Radiology
- Emergency Medicine
Background:
- Accuracy of radiologic image descriptions and labeling in medical publications is crucial for clinical practice and education.
- Previous assessments of image accuracy in emergency medicine journals are limited.
Purpose of the Study:
- To systematically evaluate the accuracy of text descriptions and labeling of radiologic images in the Canadian Journal of Emergency Medicine (CJEM).
- To assess error detection by radiologists and emergency physicians, and the clinical significance and educational value of these errors.
- To correlate errors with radiologist involvement and imaging modality.
Main Methods:
- A review of 33 issues of CJEM (January 2003 to May 2008) was conducted.
- 82 radiologic images and their accompanying text were anonymously appraised by two radiologists and two emergency physicians.
- Errors were assessed for clinical significance and educational value; underlabeled images were also identified.
Main Results:
- Of 82 images, 20 (24%) contained at least one error, totaling 23 errors (17 description, 6 labeling).
- 12 errors (52%) potentially affected clinical management or educational value.
- Articles involving radiologists had no errors, while 26% of articles without radiologists contained errors.
Conclusions:
- Radiologic images in CJEM are generally accurate, but errors impacting clinical management or education were found.
- Radiologist involvement in the publication process may enhance the accuracy and quality of published radiologic images.
Objectives:
To systematically evaluate the accuracy of text descriptions and labeling of radiologic images published in the Canadian Journal of Emergency Medicine (CJEM). Error detection by radiologists and emergency physicians and the clinical significance and educational value of these errors were assessed. Errors were also correlated with radiologist involvement in publication and imaging modality.
Methods:
Thirty-three issues of CJEM were examined from January 2003 to May 2008. Electronic copies of all radiologic images published were obtained with their caption and description from the text. Identifying information was removed to present images in an anonymous fashion. Images were presented to two radiologists who, working in consensus, critically appraised each image and accompanying text. Images were then presented to two emergency department physicians who, working in consensus, critically appraised each image and accompanying text. All images with errors detected by either radiology or emergency physicians were then discussed to determine if errors would have affected clinical management or educational value. The emergency physicians also identified "underlabeled" images where it was felt that further labeling would enhance their educational value.
Results:
Forty-five articles with 82 images were obtained. At least one error was observed in 18 (40%) articles and 20 (24%) images. Two errors were present in three images, resulting in 23 errors. Of the 23 errors, 17 were image description errors and 6 were labeling errors. Five errors were detected by both radiology and emergency physicians, whereas 15 were detected only by radiologists and 3 were detected only by emergency physicians. Of these errors, 12 (52%) were rated as potentially affecting both clinical management and educational value, 5 (22%) as only affecting educational value, and 6 (26%) as nonsignificant. Radiologists were involved in six articles, including 12 images that contained no errors. There was no official radiologist involvement in 39 articles, including 70 images, 18 (26%) of which contained errors. In addition, 26 images were identified by emergency physicians as potentially benefiting from enhanced labeling to improve educational value.
Conclusions:
Radiologic images published in the CJEM are generally of high quality; however, 23 errors were found in 82 images, 18 (78%) of which were rated as potentially affecting clinical management, educational value, or both. Radiologist involvement in the publication process may be of assistance as no errors were seen in articles that included radiologists as authors.
