title: A multiobserver study of the effects of including point-of-care patient photographs with portable radiography: a means to detect wrong-patient errors.
abstract: OBJECTIVE
  To evaluate whether the presence of facial photographs obtained at the point-of-care of portable radiography leads to increased detection of wrong-patient errors.
  
  
  METHODS
  In this institutional review board-approved study, 166 radiograph-photograph combinations were obtained from 30 patients. Consecutive radiographs from the same patients resulted in 83 unique pairs (ie, a new radiograph and prior, comparison radiograph) for interpretation. To simulate wrong-patient errors, mismatched pairs were generated by pairing radiographs from different patients chosen randomly from the sample. Ninety radiologists each interpreted a unique randomly chosen set of 10 radiographic pairs, containing up to 10% mismatches (ie, error pairs). Radiologists were randomly assigned to interpret radiographs with or without photographs. The number of mismatches was identified, and interpretation times were recorded.
  
  
  RESULTS
  Ninety radiologists with 21 ± 10 (mean ± standard deviation) years of experience were recruited to participate in this observer study. With the introduction of photographs, the proportion of errors detected increased from 31% (9 of 29) to 77% (23 of 30; P = .006). The odds ratio for detection of error with photographs to detection without photographs was 7.3 (95% confidence interval: 2.29-23.18). Observer qualifications, training, or practice in cardiothoracic radiology did not influence sensitivity for error detection. There is no significant difference in interpretation time for studies without photographs and those with photographs (60 ± 22 vs. 61 ± 25 seconds; P = .77).
  
  
  CONCLUSIONS
  In this observer study, facial photographs obtained simultaneously with portable chest radiographs increased the identification of any wrong-patient errors, without substantial increase in interpretation time. This technique offers a potential means to increase patient safety through correct patient identification.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia. Electronic address: stridan@emory.edu.
authors.forename: Srini
authors.initials: S
authors.lastname: Tridandapani
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia.
authors.forename: Senthil
authors.initials: S
authors.lastname: Ramamurthy
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322; Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: James
authors.initials: J
authors.lastname: Provenzale
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Obuchowski
authors.affiliation: The American Board of Radiology, Tucson, Arizona.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Evanoff
authors.affiliation: School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia.
authors.forename: Pamela
authors.initials: P
authors.lastname: Bhatti
mesh_terms: D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D004282:Documentation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D010355:Patient Identification Systems / Q000379:methods* / Q000706:statistics & numerical data*; D010781:Photography / Q000706:statistics & numerical data*; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013647:Task Performance and Analysis; D014481:United States
keywords: DICOM; PACS; Patient identification; digital photography; medical errors