title: Sources of error in emergency ultrasonography.
abstract: BACKGROUND
  To evaluate the common sources of diagnostic errors in emergency ultrasonography.
  
  
  METHODS
  The authors performed a Medline search using PubMed (National Library of Medicine, Bethesda, Maryland) for original research and review publications examining the common sources of errors in diagnosis with specific reference to emergency ultrasonography. The search design utilized different association of the following terms : (1) emergency ultrasonography, (2) error, (3) malpractice and (4) medical negligence. This review was restricted to human studies and to English-language literature. Four authors reviewed all the titles and subsequent the abstract of 171 articles that appeared appropriate. Other articles were recognized by reviewing the reference lists of significant papers. Finally, the full text of 48 selected articles was reviewed.
  
  
  RESULTS
  Several studies indicate that the etiology of error in emergency ultrasonography is multi-factorial. Common sources of error in emergency ultrasonography are: lack of attention to the clinical history and examination, lack of communication with the patient, lack of knowledge of the technical equipment, use of inappropriate probes, inadequate optimization of the images, failure of perception, lack of knowledge of the possible differential diagnoses, over-estimation of one's own skill, failure to suggest further ultrasound examinations or other imaging techniques.
  
  
  CONCLUSIONS
  To reduce errors in interpretation of ultrasonographic findings, the sonographer needs to be aware of the limitations of ultrasonography in the emergency setting, and the similarities in the appearances of various physiological and pathological processes. Adequate clinical informations are essential. Diagnostic errors should be considered not as signs of failure, but as learning opportunities.
authors.affiliation: Department of Diagnostic Imaging, A, Cardarelli Hospital, Naples, Italy. antopin1968@libero.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
authors.forename: Fabio
authors.initials: F
authors.lastname: Pinto
authors.forename: Angela
authors.initials: A
authors.lastname: Faggian
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rubini
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Caranci
authors.forename: Luca
authors.initials: L
authors.lastname: Macarini
authors.forename: Eugenio Annibale
authors.initials: EA
authors.lastname: Genovese
authors.forename: Luca
authors.initials: L
authors.lastname: Brunese
references.citation: Recenti Prog Med. 2012 Nov;103(11):539-41
references.pmid: 23096748
references.citation: Invest Radiol. 1988 Jan;23(1):48-55
references.pmid: 3338900
references.citation: Semin Ultrasound CT MR. 2012 Oct;33(5):443-8
references.pmid: 22964410
references.citation: Radiology. 1962 May;78:694-704
references.pmid: 13923013
references.citation: Am J Roentgenol Radium Ther Nucl Med. 1959 Jul;82(1):25-38
references.pmid: 13661490
references.citation: Australas Radiol. 2006 Jun;50(3):206-11
references.pmid: 16732815
references.citation: Radiol Med. 2012 Aug;117(5):759-71
references.pmid: 22228126
references.citation: Semin Ultrasound CT MR. 2012 Oct;33(5):385-91
references.pmid: 22964404
references.citation: Radiographics. 2009 Jul-Aug;29(4):1179-89
references.pmid: 19605664
references.citation: JAMA. 2009 Mar 11;301(10):1060-2
references.pmid: 19278949
references.citation: Int J Colorectal Dis. 2011 Sep;26(9):1191-6
references.pmid: 21538053
references.citation: Acad Emerg Med. 2009 Oct;16(10):970-7
references.pmid: 19799573
references.citation: AJR Am J Roentgenol. 1993 Dec;161(6):1167-72
references.pmid: 8249720
references.citation: J Trauma. 1990 Jun;30(6):666-9; discussion 669-70
references.pmid: 2352294
references.citation: World J Radiol. 2010 Oct 28;2(10):377-83
references.pmid: 21161023
references.citation: Radiol Clin North Am. 2008 Jul;46(4):755-71, vi
references.pmid: 18922291
references.citation: J Ultrasound Med. 2003 Jun;22(6):549-51
references.pmid: 12795551
references.citation: Singapore Med J. 2004 Jun;45(6):289-94
references.pmid: 15181526
references.citation: AJR Am J Roentgenol. 1989 Dec;153(6):1251-4
references.pmid: 2683678
references.citation: Semin Ultrasound CT MR. 2012 Aug;33(4):275-9
references.pmid: 22824117
references.citation: Birth. 1992 Jun;19(2):92-9
references.pmid: 1388437
references.citation: AJR Am J Roentgenol. 1989 Dec;153(6):1255-7
references.pmid: 2683679
references.citation: Br J Radiol. 2001 Oct;74(886):949-51
references.pmid: 11675313
references.citation: Crit Ultrasound J. 2012 Jul 02;4(1):15
references.pmid: 22871130
references.citation: Eur J Echocardiogr. 2009 May;10(3):389-94
references.pmid: 18945726
references.citation: J Trauma. 2000 Oct;49(4):600-5
references.pmid: 11038075
references.citation: Recenti Prog Med. 2012 Nov;103(11):555-8
references.pmid: 23096753
references.citation: Semin Ultrasound CT MR. 2012 Aug;33(4):308-17
references.pmid: 22824121
references.citation: West J Med. 1981 Jun;134(6):485-90
references.pmid: 7257363
references.citation: Recenti Prog Med. 2012 Nov;103(11):435-7
references.pmid: 23096727
references.citation: J Ultrasound Med. 2003 Oct;22(10):1009-15
references.pmid: 14606555
references.citation: Semin Ultrasound CT MR. 2012 Aug;33(4):379-82
references.pmid: 22824127
references.citation: Clin Radiol. 2001 Dec;56(12):938-46
references.pmid: 11795921
references.citation: Radiol Clin North Am. 1992 Mar;30(2):495-501
references.pmid: 1535869
references.citation: Aust N Z J Surg. 1993 Dec;63(12):935-9
references.pmid: 8285905
references.citation: J Gen Intern Med. 1997 Dec;12(12):770-5
references.pmid: 9436897
references.citation: J Hepatol. 2008 May;48(5):811-20
references.pmid: 18321607
references.citation: Eur J Radiol. 2008 May;66(2):246-52
references.pmid: 17629431
references.citation: Eur J Radiol. 2011 Jun;78(3):368-71
references.pmid: 21255951
references.citation: Semin Ultrasound CT MR. 2012 Aug;33(4):300-7
references.pmid: 22824120
references.citation: Br J Radiol. 1997 Nov;70(839):1085-98
references.pmid: 9536897
references.citation: Eur J Radiol. 2011 Jun;78(3):372-6
references.pmid: 21255952
references.citation: Recenti Prog Med. 2012 Nov;103(11):426-30
references.pmid: 23096725