What is the most common condition in diagnosis-related malpractice claims?

1. Fractures and dislocations
2. Infections
3. Cardiac/Vascular
4. Cancer*

• According to the Covery report, cancer is the most common condition in diagnosis-related malpractice claims at 27%.This is followed by infections at 13%, cardiac/vascular at 8%, and fractures/dislocations at 5%.

Which of the following is a major contributor to claims alleging diagnostic failure against radiologists involving breast and lung cancers?

1. Findings not directly communicated
2. Missed findings
3. Poorly written reports*
4. Technically limited imaging

• According to the Coverys report, poorly written reports is a major contributor to claims alleging diagnostic failure against radiologists involving breast and lung cancer. The remaining options are contributing factors, but not to the same degree as poorly written reports.

Approximately what percentage of radiologists will face a lawsuit during their career?

1. 1%
2. 5%
3. 7%*
4. 10%
5. 15%

• According to the article “The MalpracticeLiability of Radiology Reports: Minimizing the Risk” by Srinivasa Babu and Brooks, approximately 7% of radiologists will face a lawsuit during their career.

Which of the following is a recommendation for radiologists to reduce the risk of a malpractice claim?

1. Implement over-read and second-evaluation processes that occur on an ongoing basis with feedback given to radiologists*
2. Encourage the use of phrases such as“when appropriate” when making recommendations about follow-up imaging
3. Ensure that practices are using a random peer review process such as RADPEER to document errors rates
4. Avoid using teleradiology or nighthawk services to read overnight studies

• According to the Covery report, implementing over-read and second-evaluation processes that occur on an ongoing basis with feedback given to radiologists is a recommendation to reduce the risk of a malpractice claim.
• The remaining options are not recommendations to reduce the risk of a malpractice claim.

An advantage of structured reporting is that it prompts radiologists to continue inspecting anatomic regions on the images whether or not the radiologist has already made a pertinent diagnosis.  In so doing, structured reporting mitigates against:

1. Anchoring bias
2. Alliterative bias
3. Satisfaction of search bias*
4. Framing bias

• Satisfaction of search bias is the tendency by radiologists to terminate their search for abnormalities once they identify an initial finding that potentially explains the patient’s clinical presentation.  Structured reporting mitigates against this tendency by prompting radiologists to continue searchingall pertinent anatomic regions, regardless of whether a finding was already identified.
• Anchoring bias is reflects the undue influence that an initial impression or clinical judgment has on the evaluation of subsequently collected information. This is also known as the “primacy” effect.
• Alliterative bias commonly occurs while interpreting an imaging study with a prior comparison study that was interpreted by a colleague. Reading the colleague’s report can influence how a radiologist interprets the follow-up imaging study. This is the so-called “copy and paste” error.
• Framing bias results from a tendency to be influenced by how a question is asked or how a problem is presented. For radiologists, framing bias commonly results from the influence that the clinical history has on image interpretation