Errors in diagnostic radiology

Dr Varun Babu and Dr Henry Knipe et al.

Errors in diagnostic radiology occur for a variety of reasons related to human error, technical factors and system faults. 

Classification

Renfrew classification

This classification was proposed by Renfrew et al. 5 in 1992, and at the time of writing (July 2016) remains the most widely accepted classification.

Renfrew et al. have proposed the following classification system 1,2,4:

  • type 1: complacency
    • finding identified but attributed to wrong cause
  • type 2: faulty reasoning
    • finding identified as abnormal but attributed to wrong cause
  • type 3: lack of knowledge
    • finding identified but attributed to wrong cause due to lack of knowledge
  • type 4: under-reading
    • missed abnormality that was appreciable in retrospect
  • type 5: poor communication
    • finding identified as abnormal but poor communication to relevant clinician
  • type 6: technique
    • abnormality was not identifiable (even in retrospect) secondary to poor technique
  • type 7: prior examination
    • failure to review previous imaging results in missed finding
  • type 8: history
    • finding missed due to incomplete clinical information
  • type 9: location
    • finding missed because it was outside of region of interest
  • type 10: satisfaction of search
    • failure to find a subsequent abnormality after the initial abnormality was detected
  • type 11: complication
    • most often of interventional procedures
  • type 12: satisfaction of report
    • over-reliance on the prior report
Brook classification

Brook et al. proposed the following classification as an alternative to the Renfrew classification which takes more than human error into account 3:

  • latent errors
    • 'in-built' system or technical faults that predispose to errors
  • active failures or human error
    • diagnostic errors and misinterpretation
    • complications from procedures
    • can involved more than person or be secondary to latent errors
  • external causes
    • beyond the control of the radiologist (e.g. power failures, quenches, etc.)
  • customer causes
    • related to the patient and non-radiology staff (e.g. complying with instructions, unfamiliarity with procedure)
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Article information

rID: 31221
Synonyms or Alternate Spellings:
  • Error in diagnostic radiology
  • Reporting errors
  • Errors in diagnostic radiology

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