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Related Concept Videos

Documentation of Nursing Diagnosis01:10

Documentation of Nursing Diagnosis

The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Radiological Investigation I: X-ray and CT01:30

Radiological Investigation I: X-ray and CT

Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and the...

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Related Experiment Videos

Incidental Malignancies in the Emergency Department: Missed Diagnoses, Radiological Difficulty, and a Risk-Based

Hiromi Takayasu1,2, Kazuyuki Miyamoto1,2, Mako Kitazono1,2

  • 1Department of Emergency, Critical Care Medicine and Disaster Medicine, Showa Medical University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-ku, Yokohama City 227-8501, Kanagawa, Japan.

Journal of Clinical Medicine
|July 15, 2026
PubMed
Summary

Incidental cancers found on emergency department (ED) CT scans are missed 36% of the time. This highlights the need for better systems to ensure follow-up for patients with potential cancer diagnoses.

Keywords:
computed tomographyemergency departmentfollow-upincidental malignancymissed diagnosisradiological interpretation

Related Experiment Videos

Area of Science:

  • Radiology
  • Oncology
  • Emergency Medicine

Background:

  • Incidental malignancies detected via emergency department (ED) computed tomography (CT) scans risk delayed diagnosis if unrecognized.
  • This study investigates the prevalence, recognition rates, and follow-up risk stratification of these incidental findings.

Purpose of the Study:

  • To determine the prevalence of incidental malignancies on ED CT scans.
  • To assess the rate at which these malignancies are recognized during the initial ED visit.
  • To identify factors contributing to missed diagnoses and stratify follow-up risks.

Main Methods:

  • Retrospective review of 15,347 ED CT reports (April 2016-March 2019).
  • A standardized interpretation test involving ten board-certified emergency physicians assessing 18 cases to differentiate between inherent difficulty and situational factors in missed diagnoses.

Main Results:

  • Incidental malignancies were found in 25 patients (0.16%), with lung carcinoma being the most common (28%).
  • Of these, 36% (9 out of 25) were missed during the initial ED visit.
  • Diagnostic accuracy varied significantly among cases, with some universally missed, indicating inherent radiological difficulty rather than individual physician expertise.

Conclusions:

  • Incidental malignancies occur in 0.16% of ED CT scans, with a 36% missed diagnosis rate at initial presentation.
  • Missed diagnoses are attributed to inherent radiological difficulty and systemic factors, not individual physician skill.
  • Discharged new patients without scheduled follow-up are at the highest risk for adverse outcomes, necessitating systems-based interventions.