In a study by Dalla Palma et al. on the impact of clinical-radiological consultations, how often was the initial clinical diagnosis changed?

1. 10%
2. 25%
3. 50%*
4. 75%

• The initial clinical diagnosis was changed 50% of the time after clinical-radiological consultations.

In the setting of trauma, what relevant information in the EMR can significantly impact diagnostic errors?

1. Lab values (e.g. white count and liver function tests)
2. Tumor markers
3. Prior surgeries
4. Localizing signs and symptom*

• Localizing signs and symptoms can help direct a radiologist’s attention to subtle findings on imaging performed in the setting of trauma.
• The remaining options are more appropriate for other clinical scenarios.

When evaluating for biliary obstruction on CT after cholecystectomy, what relevant information in the EMR can impact diagnostic errors?

1. Lab values (e.g. white count and liver function tests)*
2. Tumor markers
3. Prior surgeries
4. Localizing signs and symptom

• Lab values such liver function tests(e.g. alkaline phosphatase) can be very helpful in determining whether biliary dilation on imaging is related to obstruction or prior cholecystectomy.
• The remaining options are more appropriate for other clinical scenarios.

When evaluating for recurrent tumor after prostatectomy, what relevant information in the EMR can impact diagnostic errors?

1. Lab values (e.g. white count and liver function tests)
2. Tumor markers*
3. Prior surgeries
4. Localizing signs and symptom

• Tumor markers such as PSA can be helpful in identifying subtle findings of recurrence, as well as interpreting abnormal findings such as a sclerotic lesion in the bone.
• The remaining options are more appropriate for other clinical scenarios.

Which of the following is a system-related cause of diagnostic error?

1. Hindsight bias
2. Alliterative error
3. Case complexity
4. Workload*

• System-related errors are the result of environmental factors such as workload, staffing, inefficient processes, communication errors, lack of teamwork, and interruptions.
• Hindsight bias is a cognitive bias that refers to the tendency to overestimate the predictability of an event after the event is known.
• Alliterative bias is a cognitive bias that represents the influence that one radiologist’s judgment can exert on the diagnostic thinking of another radiologist
• Case complexity may be associated with more frequent errors, but is not a system-related cause of errors.