Diagnostic errors occur mostly when radiologists exceed their average daily production, according to a new study published Thursday.
Researchers conducted a retrospective analysis of all clinical CT scans performed at a single center between 2020 and 2023. They included any exams that contained an addendum describing a perpetual error, such as the failure to detect a key abnormality, according to the analysis, published in the European Journal of Radiology [1].
Lead author Dr. Ömer Kasalak and colleagues also analyzed the time of day when mistakes occurred, along with each physicians’ workload as measured by RVUs. They found that the latter had a clear impact, while time did not affect results.
“The results of this study show that radiologists generally worked 21% harder (in terms of reported examinations and compared to their own average daily productivity) on days they made a diagnostic error,” Kasalak, a radiologist with the University Medical Center Groningen in the Netherlands, and co-authors wrote Aug. 10. “This indicates that radiologists should exercise caution when, for reasons like imaging backlogs, clinical pressure and understaffing, their caseload exceeds their normal daily production. Medical imaging utilization and the need for diagnostic radiologists are expected to keep on increasing in the foreseeable future.”
The results unearthed 49 diagnostic errors logged over the three-year study period. Mistakes most frequently occurred in the lungs (n=8), bone (n=8), lymph nodes (n=5), peritoneum (n=5) and liver (n=4). Workload on the days the diagnostic errors occurred was on average about 121%, which they deemed “significantly higher” than the average day. Kasalak et al. found that there was no significant upward trend in errors over the course of the day, nor were there any other “notable temporal trends.”
The authors suggested one possible solution to address this challenge in clinical practice.
“We agree that the available evidence does not support using absolute work limits in radiology practice, and that they may not work because of variations in reporting capacity between radiologists,” the authors noted, affirming the findings from previous studies on this topic. “However, using a relative workload metric that measures a radiologist’s daily case load against his or her known average daily productivity, as was used in the present study, may be a potential alternative. Nevertheless, it should be noted that the average daily productivity of an individual radiologist may increase (or decrease) over time, which, in turn, will affect the calculated relative workload metric. Therefore, it may be necessary to monitor average daily productivity numbers over more extended periods of time.”
Read more in EJR at the link below.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.