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How to avoid missing common radiographic findings
Daniel M. Lugassy, MD
New York University-Bellevue Hospital Center
 

https://vimeo.com/41970228


Fehlentscheidungen in der Radiologie

Fehler passieren ständig. Fehler sind Teil der menschlichen Natur und werden überall gemacht, wo Menschen in Entscheidungen involviert sind. Das Begehen von Fehlern ist eine der wichtigsten Voraussetzungen für die Weiterentwicklung geistiger und praktischer Fähigkeiten. Aus Fehlern kann man lernen, wenn man sie erkennt und über sie spricht. Gerade in der Medizin, wo Fehler rasch Leid, bleibende Behinderungen oder in seltenen Fällen gar den Tod hervorrufen können, dürfen keine Fehler passieren. Aber sie lassen sich trotz bester Absicht nicht völlig vermeiden. Ärzte sind Menschen und sie machen Fehler. Auch Ärzte müssen offen über Fehler reden und reden dürfen, um sie zukünftig zu vermeiden. Es geht hierbei um eine lösungsorientierte Fehleranalyse und nicht um Schuldzuweisungen. Das vorliegende wegweisende Buch setzt genau an dieser Stelle an. Alle dargestellten Fälle sind tatsächlich passiert und Teil regelmäßiger neutraler Fehleranalysen. Profitieren Sie vom Fundus und dem Erfahrungsschatz einer großen radiologischen Klinik, lernen Sie aus diesen Fehlern und sprechen Sie offen über Ihre eigenen Fehlentscheidungen.

http://www.amazon.de/Fehlentscheidungen-Radiologie-Ursachen-Strategien-Fehlervermeidung/dp/3131478217

 


Errors in Radiology

The main reason for studying medical errors is to try to prevent them

A radiology safety culture will only exist when the radiologist who made the error views such feedback positively as a learning experience

Identification and reduction of diagnostic error provides a measure of the efficacy of the healthcare system, as it reduces mortality, morbidity and additional healthcare costs

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. As the number of malpractice cases continues to grow, radiologists will become increasingly involved in litigation. Accordingly, every radiologist should understand the various sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation.

The principal focus of this book is on the diagnostic errors that may be perpetrated when using diverse radiologic techniques in different disease settings. The full spectrum of potential errors is analyzed with the aid of high-quality illustrations and with clear guidance on their avoidance. In addition, medicolegal aspects inherent to radiology are carefully examined, with particular attention to radiation exposure due to imaging procedures and malpractice issues relating to administration of contrast media. The importance of good communication between radiologists and physicians and between radiologists and patients is also emphasized. Errors in Radiology will prove immensely valuable to both novice and more experienced radiologists.


 

September 2013
Cognitive and System Factors Contributing to Diagnostic Errors in Radiology
Cindy S. Lee1, Paul G. Nagy1, Sallie J. Weaver1 and David E. Newman-Toker1
AJR September 2013, Volume 201, Number 3

... every radiologist worries about missing a diagnosis or giving a false-positive reading. The retrospective error rate among radiologic examinations is approximately 30%, with real-time errors in daily radiology practice averaging 3–5%. Nearly 75% of all medical malpractice claims against radiologists are related to diagnostic errors. 

Januar 2013 
Malpractice in Radiology: What Should You Worry About?
Alessandro Cannavale,1 Mariangela Santoni,2 Paola Mancarella,2 Roberto Passariello,1 and Paolo Arbarello2
Radiology Research and Practice; Volume 2013 (2013), Article ID 219259, 10 pages

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. Since the early 1970s, physicians have been subjected to an increasing number of medical malpractice claims. Radiology is one of the specialties most liable to claims of medical negligence. Most often, a plaintiff’s complaint against a radiologist will focus on a failure to diagnose. The etiology of radiological error is multi-factorial. Errors fall into recurrent patterns. Errors arise from poor technique, failures of perception, lack of knowledge and misjudgments. The work of diagnostic radiology consists of the complete detection of all abnormalities in an imaging examination and their accurate diagnosis. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation. Error traps need to be uncovered and highlighted, in order to prevent repetition of the same mistakes. This article focuses on the spectrum of diagnostic errors in radiology, including a classification of the errors, and stresses the malpractice issues in mammography, chest radiology and obstetric sonography. Missed fractures in emergency and communication issues between radiologists and physicians are also discussed. mehr ...

Oktober 2012
Spectrum of diagnostic errors in radiology
Antonio Pinto and Luca Brunese
World J Radiol. Oct 28, 2010; 2(10): 377–383. / Published online Oct 28, 2010. doi:  10.4329/wjr.v2.i10.377

April 2012 
Die Hälfte der Diagnosen falsch oder zu spät. Und das beim Verdacht Krebs. Können Tumorboards für Klarheit sorgen? Ein Markt für Zweitmeinungen entsteht.
JOACHIM MÜLLER-JUNG FAZ online 30.04.2012 

Januar 2012
Discrepancy and Error in Radiology: Concepts, Causes and Consequences
Adrian Brady, Risteárd Ó Laoide, Peter McCarthy, and Ronan McDermott
Ulster Med J. Jan 2012; 81(1): 3–9. - © The Ulster Medical Society, 2012

Februar 2012
Common patterns in 558 diagnostic radiology errors
Jennifer J Donald* andStuart A Barnard
Journal of Medical Imaging and Radiation Oncology; Volume 56, Issue 2, pages 173–178, April 2012

2007
Aus- und Weiterbildung in Patientensicherheit und Fehlerkultur
Projekt << Zukunft Medizin Schweiz >> Phase III
SAMW Schweizische Akademie der Medizinischen Wissenschaften

Im Jahr 2000 hat das Bundesamt für Gesundheit mit der Mitteilung, wonach in der Schweiz pro Jahr rund 3000 Menschen wegen medizinischer Behandlungsfehler sterben, in der Öffentlichkeit für Aufsehen gesorgt. Ähnliche Zahlen gibt es auch aus anderen Ländern.
Obwohl das Gesundheitswesen also ein hohes Fehlerpotenzial aufweist, besteht eine eigentliche Kultur im Umgang mit Fehlern erst im Ansatz. Mit der Gründung der «Stiftung für Patientensicherheit» wurde diesbezüglich in der Schweiz immerhin ein erster, wichtiger Schritt getan. mehr ...

Oktober 2010
Spectrum of diagnostic errors in radiology
Antonio Pinto and Luca Brunese
World J Radiol. Oct 28, 2010; 2(10): 377–383.

September 2007
Radiologic Errors and Malpractice: A Blurry Distinction
Leonard Berlin
American Journal of Roentgenology.2007; 189; September 2007, Volume 189, Number 3

November 1997
Radiology's Achilles' heel: error and variation in the interpretation of the Röntgen image.
P J Robinson
British Institute of Radiology (BJR); Volume 70 Issue 839, November 1997

The performance of the human eye and brain has failed to keep pace with the enormous technical progress in the first full century of radiology. Errors and variations in interpretation now represent the weakest aspect of clinical imaging. Those interpretations which differ from the consensus view of a panel of "experts" may be regarded as errors; where experts fail to achieve consensus, differing reports are regarded as "observer variation". Errors arise from poor technique, failures of perception, lack of knowledge and misjudgments. Observer variation is substantial and should be taken into account when different diagnostic methods are compared; in many cases the difference between observers outweighs the difference between techniques. Strategies for reducing error include attention to viewing conditions, training of the observers, availability of previous films and relevant clinical data, dual or multiple reporting, standardization of terminology and report format, and assistance from computers. Digital acquisition and display will probably not affect observer variation but the performance of radiologists, as measured by receiver operating characteristic (ROC) analysis, may be improved by computer-directed search for specific image features. Other current developments show that where image features can be comprehensively described, computer analysis can replace the perception function of the observer, whilst the function of interpretation can in some cases be performed better by artificial neural networks. However, computer-assisted diagnosis is still in its infancy and complete replacement of the human observer is as yet a remote possibility. mehr ...

 

Letzte Änderung am: 03.10.2015