Medical legal evaluations on the radiological error: has the use of PACS introduced changes in cognitive errors?

The introduction of PACS (Picture Archiving and Communication System) digital image archiving systems has changed the way radiologists work. We refer to a new typology of cognitive error that we can define as confirmation compulsion. It is a behavior that includes components of emotional influence, contour influence and the tendency to alliteration. The frequent possibility of comparing previous exams on the same reporting console leads radiologists to automatically compare with the latest exam being viewed. This operational methodology is not suitable for the identification of slowly evolving pathologies whose changes can only be appreciated through comparative evaluation considering time intervals longer than 6-12 months and equal, for example, to 24 months. This type of error is avoided by comparing with exams from two or three previous years.