Diagnostic errors in abdominopelvic CT interpretation: characterization based on report addenda

Area of Science:

• Radiology and Medical Imaging
• Diagnostic Accuracy
• Health Informatics

Background:

• Diagnostic errors in medical imaging can impact patient care.
• Abdominopelvic computed tomography (CT) is a crucial diagnostic tool.
• Radiology report addenda are used to correct or update initial interpretations.

Purpose of the Study:

• To characterize the types and frequencies of diagnostic errors identified in abdominopelvic CT interpretations.
• To analyze the reasons behind these diagnostic errors as documented in radiology report addenda.

Main Methods:

• A retrospective review of abdominopelvic CT reports was conducted over a seven-year period.
• Reports containing the term "addendum" were identified and analyzed for diagnostic errors.
• Cases were categorized by error type, affected anatomic site, and contributing factors.

Main Results:

• 709 addenda identified 785 diagnostic errors, representing approximately 0.5% of reports.
• Missed findings constituted 84.1% of errors, with vasculature and abdominal wall being common sites.
• Reasons for changes included comparison with prior imaging (30.6%) and additional surgical history (22.5%).

Conclusions:

• Missed findings are the primary driver of diagnostic errors in abdominopelvic CT reports.
• Understanding common misses by location can inform quality assurance efforts.
• Optimizing informatics and physician communication may reduce diagnostic errors.