Radiologists infrequently misidentify body side of lesion

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Clinically significant errors were found in reporting the body side of the lesion in radiology reports between the body and impression sections, according to a study in the May issue of the American Journal of Roentgenology.

Minal Jagtiani Sangwaiya, MD, and colleagues from the department of radiology at Massachusetts General Hospital in Boston, undertook a study to determine the frequency of discrepancies in side of findings (side discrepancies) in the body and the impression sections of radiology reports. In addition, they sought to determine the frequency of corrected side discrepancies between radiology reports and images in a larger database of radiology reports.

In this retrospective study, all radiology reports from Jan. 1, 2007, through Dec. 31, 2007 (1,065,322 reports), that had an addendum were assessed using a radiology reports search engine and searching for the words "left," "right" and "addendum" to locate laterality errors between the body of the report and the impression section, according to the researchers.

For reports with discrepancies, they recorded the patient's sex, true side of the lesion and the imaging technique. All reports (13,821) with an addendum in January 2007 contained the words "left" and "right" were evaluated using the same search engine for similar discrepancies. The investigators reviewed the imaging studies of reports with errors to determine the correct side of the lesion and the clinical significance of the errors.

Of the 1,065,322 reports, Sangwaiya and colleagues found that 88 side discrepancies were reported in addenda. The errors in mislabeling the side of the lesion were more common in female (58) than in male (30) patients. Of the 88 errors reported in addenda, 27 were labeled incorrectly in the body of the report, 29 in the impression section, and 32 in both the body and impression sections.

In January 2007, 0.26 percent of the reports had no correction for mislabeling of side. However, the researchers said that 70.9 percent of the errors were graded as clinically important.

They also found that although approximately 50 percent of laterality errors in radiology reports were deemed clinically important, most of these errors were not subsequently rectified. In fact, most discrepancies were not identified over a one-year period of follow-up in the study. The researchers also noted that mammography was the most common imaging technique for errors for "unclear" reasons. The authors noted that their study "raises awareness among radiologists and referring physicians that errors in laterality of findings can occur and should be anticipated."