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 >
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The Health Advocate • MAY 2021
