The Health Advocate – May 2021

Page 60

DR SEAN DOCKING Deeble Summer Scholar Research Fellow Epidemiology Monash Department of Clinical Epidemiology Cabrini Insititute

Reducing diagnostic errors related to medical imaging

In Australia, 9.6 million patients underwent a medical imaging service in 2018-19 — with the aim of aiding health practitioners in diagnostic and treatment decision-making. However, its use can lead to diagnostic errors.

It is estimated that 140,000 diagnostic errors occur

range of cognitive biases or psychophysiological

in Australia each year, including errors related

factors related to human visual perception.2

to medical imaging.1 Diagnostic errors in medical

However, it is important to note that not all

imaging can occur during the referral stage,

failures will result in patient harm.

during the interpretation of the image, and

Integration stage

when the findings from the images are integrated into the diagnostic work-up that informs health care decisions.

The process of integrating imaging findings with clinical symptoms and patient history is a particularly vulnerable step to diagnostic errors.

Referral stage

For example, disc degeneration is often found

Inappropriate referral, referral for medical

when imaging for non-specific low back pain, but

imaging that is unlikely to inform diagnosis or the

this finding has also been found to occur in a large

future management of a condition, can increase

proportion of pain-free individuals; suggesting that

the likelihood of a diagnostic error occurring.

disc degeneration is not the source of pain and

Selecting the most appropriate imaging modality,

does not require targeted treatment.

for example x-ray vs MRI, to support the diagnostic

Identifying diagnostic errors

process is essential to reducing diagnostic errors.

In Australia, diagnostic errors have been

Interpretation stage

responsible for the majority of medical indemnity

The failure to identify an abnormality that is

claims.3 However, more contemporary analysis is

present on medical imaging is estimated to occur

needed to understand the clinical conditions and

in one in every three imaging studies due to a

settings in which diagnostic errors occur most >

60

The Health Advocate • MAY 2021


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The Health Advocate – May 2021 by Australian Healthcare and Hospitals Association - Issuu