Error and cognitive bias in diagnostic radiology.

Qiao Xin Tee; Mithun Nambiar; Stephen Stuckey

Commentary

Error and cognitive bias in diagnostic radiology.

April 13, 2022

Tee QX, Nambiar M, Stuckey S. J Med Imaging Radiat Oncol. 2022;66(2):202-207.

View more articles from the same authors.

Diagnostic errors in radiology can result in treatment delays and contribute to patient harm. This article provides an overview of the common cognitive biases encountered in diagnostic radiology that can contribute to diagnostic error, and strategies to avoid these biases, such as the use of a cognitive bias mitigation strategy checklist, peer feedback, promoting a just culture, and technology approaches including artificial intelligence (AI).

PubMed citation

Available at

Related Resources From the Same Author(s)

Quality Special Issue.

April 13, 2022

Mandating limits on workload, duty, and speed in radiology.

July 6, 2022

Safety considerations for IMRT.

August 10, 2011

Diagnostic challenges in primary care: identifying and avoiding cognitive bias.

June 29, 2022

Visual illusions in radiology: untrue perceptions in medical images and their implications for diagnostic accuracy.

August 11, 2021

A blinded, prospective study of error detection during physician chart rounds in radiation oncology.

October 14, 2020

Missing the near miss: recognizing valuable learning opportunities in radiation oncology.

December 16, 2020

'More than words' - interpersonal communication, cognitive bias and diagnostic errors.

August 11, 2021

Emotional harm in the radiology department: analysis of an underrecognized preventable error.

February 9, 2022

Reducing diagnostic errors in the emergency department at the time of patient treatment.

March 29, 2023

ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection.

April 1, 2020

A perfect storm averted: flawed systems, a dropped ball, and cognitive biases delay a critical diagnosis.

November 2, 2022

Cognitive biases encountered by physicians in the emergency room.

November 9, 2022

Investigating the impact of cognitive bias in nursing documentation on decision-making and judgement.

April 20, 2022

The fusion of incident learning and failure mode and effects analysis for data-driven patient safety improvements.

March 17, 2021

Physicians and cognitive decline: a challenge for state medical boards.

September 7, 2022

Clinical reasoning in dire times- analysis of cognitive biases in clinical cases during the COVID-19 pandemic.

February 23, 2022

A comprehensive quality assurance program for personnel and procedures in radiation oncology: value of voluntary error reporting and checklists.

August 7, 2013

Fundamentals of diagnostic error in imaging.

October 10, 2018

Errors in breast imaging: how to reduce errors and promote a safety environment.

July 7, 2021

From mindless to mindful practice—cognitive bias and clinical decision making.

July 31, 2013

Racial and ethnic differences in emergency department diagnostic imaging at US Children's Hospitals, 2016-2019.

January 4, 2021

Radiologists make more errors interpreting off-hours body CT studies during overnight assignments as compared with daytime assignments.

September 9, 2020

Multilevel factors associated with time to biopsy after abnormal screening mammography results by race and ethnicity.

July 6, 2022

Differential diagnosis checklists reduce diagnostic error differentially: a randomised experiment.

January 26, 2022

Learning through experience: influence of formal and informal training on medical error disclosure skills in residents.

April 19, 2017

Pediatric musculoskeletal radiographs: anatomy and fractures prone to diagnostic error among emergency physicians.

August 3, 2022

Identifying patients whose symptoms are underrecognized during treatment with breast radiotherapy.

May 4, 2022

Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study.

August 19, 2020

Human factors and systems engineering approach to patient safety for radiotherapy.

August 6, 2008

Biasing influence of 'mental shortcuts' on diagnostic decision-making: radiologists can overlook breast cancer in mamograms when prior diagnostic information is available.

March 30, 2022

How to reduce stigma and bias in clinical communication: a narrative review.

October 12, 2022

Implicit bias in healthcare professionals: a systematic review.

January 19, 2022

Qualitative content analysis: a framework for the substantive review of hospital incident reports.

March 23, 2022

Cognitive and implicit biases in nurses' judgment and decision-making: a scoping review.

July 13, 2022

Medical overuse as a physician cognitive error: looking under the hood.

December 12, 2018

Countering cognitive biases in minimising low value care.

June 7, 2017

The safety and acceptability of using telehealth for follow-up of patients following cancer surgery: a systematic review.

March 29, 2023

The COVID trap: pediatric diagnostic errors in a pandemic world.

August 25, 2021

Clinical progress note: situation awareness for clinical deterioration in hospitalized children.

May 11, 2022

Opioids and falls risk in older adults: a narrative review.

May 25, 2022

Improving diagnosis: adding context to cognition.

September 7, 2022

Measure Dx: implementing pathways to discover and learn from diagnostic errors.

September 28, 2022

Effect on diagnostic accuracy of cognitive reasoning tools for the workplace setting: systematic review and meta-analysis.

September 14, 2022

Adverse events in infants less than 6 months of age after ambulatory surgery and diagnostic imaging requiring anesthesia.

August 10, 2022

Oncologic errors in diagnostic radiology: a 10-year analysis based on medical malpractice claims.

November 10, 2021

Tackling implicit bias in health care.

August 17, 2022

Pursuit of "endpoint diagnoses" as a cognitive forcing strategy to avoid premature diagnostic closure.

December 21, 2022

The effects of leadership curricula with and without implicit bias training on graduate medical education: a multicenter randomized trial.

May 18, 2022

Medication use and cognitive impairment among residents of aged care facilities.

June 23, 2021

Analysis of lawsuits related to diagnostic errors from point-of-care ultrasound in internal medicine, paediatrics, family medicine and critical care in the USA.

June 24, 2020

Factors impacting on patient setup analysis and error management during breast cancer radiotherapy.

November 9, 2022

Malpractice cases in breast surgery: an assessment of litigation involving surgeons.

December 1, 2021

Cognitive bias impact on management of postoperative complications, medical error, and standard of care.

November 4, 2020

Cognitive bias and public health policy during the COVID-19 pandemic.

July 22, 2020

Evaluating incident learning systems and safety culture in two radiation oncology departments.

February 16, 2022

Evidence of bias and variation in diagnostic accuracy studies.

February 14, 2006

Impact of the COVID-19 pandemic on cancer care: a global collaborative study.

November 11, 2020

Mitigating racial bias in machine learning.

June 22, 2022

Reducing diagnostic errors—why now?

September 30, 2015

Systematic review of the impact of physician implicit racial bias on clinical decision making.

May 5, 2017

Cognitive aids in the management of clinical emergencies: a systematic review.

January 18, 2023

Involving patients and carers in patient safety in primary care: a qualitative study of a co-designed patient safety guide.

February 15, 2023

Diagnostic errors in paediatric cardiac intensive care.

February 21, 2018

Planning for a pandemic: mitigating risk to radiation therapy service delivery in the COVID-19 era.

July 22, 2020

April 27, 2022

Transformational leadership in nursing and medication safety education: a discussion paper.

June 1, 2016

How to mitigate the effects of cognitive biases during patient safety incident investigations.

September 28, 2022

Medication safety in older adults: home-based practice patterns.

June 22, 2005

Improving diagnostic decision support through deliberate reflection: a proposal.

November 9, 2022

Impact of technological and departmental changes on incident rates in radiation oncology over a seventeen-year period.

June 30, 2021

Are pathologists self-aware of their diagnostic accuracy? Metacognition and the diagnostic process in pathology.

October 5, 2022

Diagnostic errors in pediatric critical care: a systematic review.

April 28, 2021

The girl who cried pain: a bias against women in the treatment of pain.

January 2, 2001

Understanding and confronting our mistakes: the epidemiology of error in radiology and strategies for error reduction.

November 11, 2015

Survey of cancer care providers' attitude toward care for older adults with cancer during the COVID-19 pandemic.

November 25, 2020

Automated identification of diagnostic labelling errors in medicine.

June 8, 2022

Finding diagnostic errors in children admitted to the PICU.

February 8, 2017

Emotional exhaustion among US health care workers before and during the COVID-19 pandemic, 2019-2021.

October 5, 2022

The randomized AMBORA trial: impact of pharmacological/pharmaceutical care on medication safety and patient-reported outcomes during treatment with new oral anticancer agents.

April 21, 2021

Diagnostic delays in infectious diseases.

September 28, 2022

Emergency departments are higher-risk locations for wrong blood in tube errors.

September 29, 2021

Reliability, uncertainty and the management of error: new perspectives in the COVID-19 era.

March 9, 2022

Moving beyond implicit bias in antiracist academic medicine initiatives.

September 7, 2022

Diagnostic error in pediatrics: a narrative review.

March 23, 2022

Fatigue in nurses and medication administration errors: a scoping review.

March 8, 2023

Patient Safety in Surgery.

February 14, 2018

Learning from diagnostic errors to improve patient safety when GPs work in or alongside emergency departments: incorporating realist methodology into patient safety incident report analysis.

January 12, 2022

Flexibilization of science, cognitive biases, and the COVID-19 pandemic.

September 23, 2020

Cognitive biases in surgery: systematic review.

March 1, 2023

Near miss research in the healthcare system: a scoping review.

May 25, 2022

Association between hospital acquired harm outcomes and membership in a national patient safety collaborative.

August 10, 2022

The effects of three consecutive 12-hour shifts on cognition, sleepiness, and domains of nursing performance in day and night shift nurses: a quasi-experimental study.

October 20, 2021

The influence of organizational culture, climate and commitment on speaking up about medical errors.

December 18, 2019

Patients' willingness and ability to identify and respond to errors in their personal health records: mixed methods analysis of cross-sectional survey data.

July 27, 2022

Reasons for bias in ambulance clinicians' assessments of non-conveyed patients: a mixed-methods study.

May 25, 2022

Description of the role of pharmacist independent double checks during cognitive order verification of outpatient parenteral anti-cancer therapy.

March 24, 2021

The impact of COVID-19 workflow changes on radiation oncology incident reporting.

November 2, 2022

An act of performance: exploring residents' decision-making processes to seek help.

April 14, 2021

Do no harm: reaffirming the value of evidence and equipoise while minimizing cognitive bias in the COVID-19 era.

August 12, 2020

Related Resources

Artificial intelligence-supported screen reading versus standard double reading in the Mammography Screening with Artificial Intelligence trial (MASAI): a clinical safety analysis of a randomised, controlled, non-inferiority, single-blinded, screening accuracy study.

November 15, 2023

Psychological safety as a new ACGME requirement: a comprehensive all-in-one guide to radiology residency programs.

November 8, 2023

Right Kind of Wrong: Why Learning to Fail can Teach us to Thrive.

October 18, 2023

Diagnostic reliability in teledermatology: a systematic review and a meta-analysis.

August 30, 2023

Patient, carer and family experiences of seeking redress and reconciliation following a life-changing event: systematic review of qualitative evidence.

August 2, 2023

Patient Safety Innovations

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

July 31, 2023

Sociotechnical work system approach to occupational fatigue.

July 26, 2023

Systems approach to suicide prevention: strengthening culture, practice, and education.

June 28, 2023

Reducing errors resulting from commonly missed chest radiography findings.

May 31, 2023

Diagnostic errors in musculoskeletal oncology and possible mitigation strategies.

May 24, 2023

Individual characteristics that promote or prevent psychological safety and error reporting in healthcare: a systematic review.

May 10, 2023

Listening, Learning, Responding to Concerns.

April 12, 2023

Racism and electronic health records (EHRs): perspectives for research and practice.

April 12, 2023

Reducing diagnostic errors in the emergency department at the time of patient treatment.

March 29, 2023

The influence of professional identity on how the receiver receives and responds to a speaking up message: a cross-sectional study.

March 29, 2023

Using A.I. to detect breast cancer that doctors miss.

March 15, 2023

How should clinicians minimize bias when responding to suspicions about child abuse?

February 22, 2023

A failure in the medication delivery system-how disclosure and systems investigation improve patient safety.

January 11, 2023

The prosecution of RaDonda Vaught: an ethical and legal mistake.

December 21, 2022

Factors impacting on patient setup analysis and error management during breast cancer radiotherapy.

November 9, 2022

Improving diagnostic decision support through deliberate reflection: a proposal.

November 9, 2022

A perfect storm averted: flawed systems, a dropped ball, and cognitive biases delay a critical diagnosis.

November 2, 2022

Developing the Safer Dx Checklist of Ten Safety Recommendations for Health Care Organizations to address diagnostic errors.

October 12, 2022

Rooting an error review process in just culture: lessons learned.

October 5, 2022

Sixty seconds on . . . medical gaslighting.

September 14, 2022

Patterns of error in interpretive pathology.

August 17, 2022

Neuroradiology diagnostic errors at a tertiary academic centre: effect of participation in tumour boards and physician experience.

August 17, 2022

An evolution of reporting: identifying the missing link.

August 10, 2022

Machine learning models outperform manual result review for the identification of wrong blood in tube errors in complete blood count results.

June 29, 2022

A learning health system agenda for organizational approaches to enhancing occupational well-being among clinicians.

May 25, 2022

See More About The Topic

Ambulatory Clinic or Office

Health Care Providers

Radiology

Diagnostic Test Interpretation Error

Psychological and Social Complications

Error and cognitive bias in diagnostic radiology.

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Error and cognitive bias in diagnostic radiology.

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site