Factors Affecting Interpretative Accuracy: How Can We Reduce Errors?
Radiology. 2018 Apr;287(1):213-214. doi: 10.1148/radiol.2017172781. Arenson RL1.
In the accompanying article, “Effect of Shift, Schedule, and Volume on Interpretative Accuracy: A Retrospective Analysis of 2.9 Million Radiologic Examinations,” Hanna et al (1) demonstrate that long shifts and high examination volume lead to increased interpretative discrepancies between preliminary and secondary readers. This analysis provides insight into reasons for diagnostic errors and adds to the body of knowledge that should help us to improve our diagnostic accuracy.
There are certainly other factors that affect our accuracy, and one that possibly needs more attention is the advanced training and experience of subspecialty-trained radiologists. The authors of the accompanying article mention that some of the preliminary and subsequent readers have subspecialty training, but there is no mention that they concentrated on examinations that matched their subspecialties. Authors of a number of articles have analyzed the effect of such subspecialization and have demonstrated significant improvement in diagnostic accuracy in various areas.
Sickles et al (2) examined the effect on both screening and diagnostic mammography and found that the subspecialists detected significantly more cancers, recommended more biopsies, and had lower recall rates than did the generalists. Mullerad et al (3) analyzed the predictive value of various techniques in endorectal magnetic resonance imaging for prostate cancer. They found that in the hands of genitourinary radiologists, the diagnosis of extracapsular extension was substantially improved.