abstManagement-changing errors in the recall of radiologic results — A pilot study Clinical Radiology

Management-changing errors in the recall of radiologic results — A pilot study

Aim

To evaluate the occurrence of alterations to diagnostic information from radiological studies, which are altered by person-to-person communication and/or faulty recall, and whether they affect patient management

Materials and methods

A structured telephone survey was conducted at a large tertiary care medical centre of house staff managing inpatients who had undergone chest, abdominal, or pelvic computed tomography (CT) or magnetic resonance imaging (MRI) and remained in the hospital at least 2 days later.  

Fifty-six physicians were surveyed regarding 98 patient cases. Each physician was asked how he or she first became aware of the results of the study. Each was then asked to recall the substance of radiological interpretation and to compare it with the radiology report. Each was then asked to assess the level of difference between the interpretations and whether management was affected. Results were correlated with the route by which interviewees became aware of the report, the report length, and whether the managing service was medical or surgical.

Results

In nearly 15% (14/98) of cases, differences between the recalled and official results were such that patient management could have been (11.2%) or had already been affected (3.1%). There was no significant correlation between errors and either the route of report communication or the report length.

Conclusion

There was a substantial rate of error in the recall and/or transmission of diagnostic radiological information, which was sufficiently severe to affect patient management.

National Guideline Clearinghouse | ACR practice guideline for communication of diagnostic imaging findings.

Blogger's Note: selected section of interest:
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Self-Referred and Third Party Referred Patients
Most patients having imaging procedures are referred by physicians or other health care professionals. Some patients, however, are self-referred, such as for mammography, or are referred by a third party, such as an insurer or employer.

1. Self-Referred Patients Interpreting physicians should recognize that performing imaging studies on self-referred patients establishes a doctor-patient relationship that includes responsibility for communicating the results of imaging studies directly to the patient and arranging for appropriate follow-up.
   

2. Third-Party Referred Patients It is not unusual for patients to be referred for imaging studies by insurance companies, employers, federal benefits programs, and in some instances lawyers. In such cases the reports of the studies are frequently communicated through the requesting entity to a clinician or directly to the third-party-designated clinician. The results of the examinations are then communicated to the patient either directly by the third party or by its designated clinician. Regardless of the source of the referral, the interpreting physician has an ethical responsibility to ensure communication of unexpected or serious findings to the patient. Therefore, in certain situations the interpreting physician may feel it is appropriate to communicate the findings directly to the patient.