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PubMed · 12014235

[Errors in radiologic studies].

W P Th M Mali
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Abstract

The interpretation of imaging studies is associated with missed diagnoses. These are due to the inherent limitations of the technique, which are quantified in the sensitivity and specificity of the test and can be caused by normal variation in the interpretation. This can be studied in the reproducibility. Another source of missed diagnoses is related to the observer and is the result of an inadequate technique, mistakes in perception and judgement, and a lack of knowledge. Here, perception error is probably the most important category. A reproachable error is made when a group of experts states that the error should not have been made. Some basic questions that can be posed to reach a judgement in such cases are: was the work conducted in accordance with a protocol, how were the films read and what was the clinical context? The missing of an abnormality on a film can only be judged against the background of the diagnostic handling around such a clinical problem and the quality of the observer.

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Diagnostic ErrorsHumansObserver VariationRadiographic Image Interpretation, Computer-AssistedRadiographyRadiologySensitivity and SpecificityCommentEnglish AbstractJournal Article

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W P Th M Mali. 2002-04-27. [Errors in radiologic studies].. https://pubmed.ncbi.nlm.nih.gov/12014235/

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The incidence and severity of adverse events affecting patients after discharge from the hospital.

BACKGROUND: Studies of hospitalized patients identify safety as a significant problem, but few data are available regarding injuries occurring after discharge. Patients may be vulnerable during this transition period. OBJECTIVE: To describe the incidence, severity, preventability, and "ameliorability" of adverse events affecting patients after discharge from the hospital and to develop strategies for improving patient safety during this interval. DESIGN: Prospective cohort study. SETTING: A tertiary care academic hospital. PATIENTS: 400 consecutive patients discharged home from the general medical service. MEASUREMENTS: The three main outcomes were adverse events, defined as injuries occurring as a result of medical management; preventable adverse events, defined as adverse events judged to have been caused by an error; and ameliorable adverse events, defined as adverse events whose severity could have been decreased. Posthospital course was determined by performing a medical record review and a structured telephone interview approximately 3 weeks after each patient's discharge. Outcomes were determined by independent physician reviews. RESULTS: Seventy-six patients had adverse events after discharge (19% [95% CI, 15% to 23%]). Of these, 23 had preventable adverse events (6% [CI, 4% to 9%]) and 24 had ameliorable adverse events (6% [CI, 4% to 9%]). Three percent of injuries were serious laboratory abnormalities, 65% were symptoms, 30% were symptoms associated with a nonpermanent disability, and 3% were permanent disabilities. Adverse drug events were the most common type of adverse event (66% [CI, 55% to 76%]), followed by procedure-related injuries (17% [CI, 8% to 26%]). Of the 25 adverse events resulting in at least a nonpermanent disability, 12 were preventable (48% [CI, 28% to 68%]) and 6 were ameliorable (24% [CI, 7% to 41%]). CONCLUSION: Adverse events occurred frequently in the peridischarge period, and many could potentially have been prevented or ameliorated with simple strategies.

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