How Do We Understand Common Cognitive Errors Radiologists Make?

Making a diagnostic error is something that many radiologists will grapple with in their careers. According to a study from Johns Hopkins University School Medicine, nearly 75 percent of all medical malpractice suits against radiologists are pursued on the basis of diagnostic errors.  

The study’s researchers attribute overwhelming work responsibilities, increased expectations, bureaucratic protocol, and cognitive biases to diagnostic errors in the field. Cognitive errors are comprised of “faulty perception, failed heuristics, and biases.” They’re essentially shortcuts radiologists utilize in order to make timely and cost-effective decisions. When radiologists make an error due to cognitive bias, it’s usually a result of poor and quickly judgement, “perceptual distortion” and “illogical interpretation.” They’re errors that radiologists have made repeatedly that have become almost a subconscious pattern.

For example, if a radiologist failed to identify lung cancer on a chest radiograph, there is a strong likelihood that he or she will overcall a potential lung nodules on a future radiograph. This is called “Availability Bias.” The researchers urge radiologists to be aware of impulse to overestimate the rate of previously misidentified, neglected, or striking cases. They also discuss the tendency to announce a diagnosis before it’s been fully verified. They call this “Premature Closure, and describe its complications in the following example:

“In a patient with myasthenia gravis and a homogeneous mediastinal mass seen on chest CT, a diagnosis of thymoma might be made, even though thymic hyperplasia, lymphoma, and germ cell tumors remain on the differential diagnosis.”

In avoiding Premature Closure, the researchers recommend making a final diagnosis only after they’ve conducted a full pathologic verification. Check out the full study to read more about the most common diagnostic errors radiologists make.