E5130. Estimating the Total Errors in a Radiology Career
  1. Quoc-Huy Ly; Yale School of Medicine
  2. Saif Zaman; Yale School of Medicine
  3. Alex Kuehne; Yale School of Medicine
  4. Long Tu; Yale School of Medicine
Errors are an expected part of radiologic practice. In the literature, there are longstanding estimations that interpretative error occurs in approximately 4% of radiologic studies. Based on the 2009 RADPEER study, one of the only large-scale studies on major discrepancy rate among radiologists, it was found that in 0.07% of all studies, there was “serious” error in which there was a misinterpretation of findings when the diagnosis should be made every time. There has not been a quantitative estimate of error rate and serious error rate on the individual scale throughout the course of a radiology career. This study aims to provide a quantitative reference for error and provide a context for understanding malpractice related to error.

Materials and Methods:
The literature was reviewed for average error rate, serious error rate, average study volume, and malpractice litigation rate per radiologist. Quantitative calculation and deterministic sensitivity analysis was then performed to produce estimations of error rates on the individual scale.

When applying a 4% error rate to estimations of annual workload for the average radiologist (15,000 diagnostic studies per year published in 2006–2007 and likely more in the present), a radiologist will theoretically commit on average 600 errors in a year, or 18,000 errors in a 30-year career. In the 2009 RADPEER study, one of the only large-scale studies on major discrepancy rates among radiologists, 0.07% of studies had a serious error in which there was misinterpretation of findings when the diagnosis should have been made. Therefore, an average radiologist may expect to commit approximately 10 serious errors per year, and approximately 300 serious errors in a 30-year career. Variations of 50–100% total error are plausible with varying input parameters.

Errors, including serious errors, are an expected part of radiologic practice. Essentially all radiologists are expected to commit hundreds of serious errors throughout their career. However, only 30% of radiologists report that they have been named in a malpractice claim. Less than 1% of serious errors are therefore represented in malpractice suits. Because medical errors, even serious ones, are common, malpractice suits cannot differentiate between the more or less accurate radiologist. For example, a more accurate radiologist may only generate over a lifetime 200 serious errors, versus a less accurate 400. If both are never grossly negligent, these serious errors can be considered inevitable due to human imperfection. Estimating total errors in a radiology career allows recognition of the human, fallible nature of medical care. Fear of litigation and the experience of malpractice suits negatively impacts physicians. Our findings can motivate the creation of systems that recompensate those affected by adverse events without requiring that fault be found. Such systems would be to the benefit of physicians and patients alike.