Learning from diagnostic errors: a good way to improve education in radiology.
OBJECTIVE
To evaluate the causes and the main categories of diagnostic errors in radiology as a method for improving education in radiology.


METHODS
A Medline search was performed using PubMed (National Library of Medicine, Bethesda, MD) for original research publications discussing errors in diagnosis with specific reference to radiology. The search strategy employed different combinations of the following terms: (1) diagnostic radiology, (2) radiological error and (3) medical negligence. This review was limited to human studies and to English-language literature. Two authors reviewed all the titles and subsequently the abstracts of 491 articles that appeared pertinent. Additional articles were identified by reviewing the reference lists of relevant papers. Finally, the full text of 75 selected articles was reviewed.


RESULTS
Several studies show that the etiology of radiological error is multi-factorial. The main category of claims against radiologists includes the misdiagnoses. Radiologic "misses" typically are one of two types: either missed fractures or missed diagnosis of cancer. The most commonly missed fractures include those in the femur, the navicular bone, and the cervical spine. The second type of "miss" is failure to diagnose cancer. Lack of appreciation of lung nodules on chest radiographs and breast lesions on mammograms are the predominant problems.


CONCLUSIONS
Diagnostic errors should be considered not as signs of failure, but as learning opportunities.
Department of Diagnostic Imaging, A. Cardarelli Hospital, I-80131 Naples, Italy. antopin1968@libero.it
Antonio
A
Pinto
Ciro
C
Acampora
Fabio
F
Pinto
Elena
E
Kourdioukova
Luigia
L
Romano
Koenraad
K
Verstraete
D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D016239:MEDLINE / Q000706:statistics & numerical data*; D058996:Quality Improvement / Q000706:statistics & numerical data*; D011871:Radiology / Q000193:education* / Q000706:statistics & numerical data*