Over the past decade, radiological imaging tests - including CT scanning, MRI, PET, X-rays, ultrasound, fluoroscopy and other modalities - have become essential to the routine diagnostic process. While these modern advanced medical images and their striking anatomic detail have discovered underlying issues, they have also contributed to a false impression of infallibility. Unlike other straightforward diagnostic tests, such as the EKG or blood chemistry panel, radiological imaging tests are highly variable and complex, often yielding uncertain results, as well as frequent false-negatives and false-positives. The experts who interpret the images (the diagnostic radiologists) sometimes make mistakes: the practice of diagnostic radiology is a fallible, human endeavour, one involving complex perceptual, neuro-physiological and cognitive processes employed under a wide range of circumstances, and with a great deal of variability. Error and Uncertainty in Diagnostic Radiology opens the 'black box,' of medical imaging, exposing the remarkable inner workings of the process of diagnostic radiology-including how and why it can sometimes go tragically wrong. The occurrence of radiological error is shown to be fundamentally intertwined with the underlying high level of uncertainty known to be present in the diagnostic process. As a foremost expert on radiology quality and safety, Dr. Bruno provides insight into the various types of radiologist error, along with a conceptual framework for understanding error and uncertainty in radiology, leading to practical strategies for error prevention and for reducing the risk of harm to patients when errors inevitably occur. This book is essential for radiologists, members of the Society to Improve Diagnosis in Medicine, emergency physicians, medical educators, medical and hospice administrators, especially quality and safety officers, as well as malpractice insurance carriers.

Over the past decade, radiological imaging tests - including CT scanning, MRI, PET, X-rays, ultrasound, fluoroscopy and other modalities - have become essential to the routine diagnostic process. While these modern advanced medical images and their striking anatomic detail have discovered underlying issues, they have also contributed to a false impression of infallibility. Unlike other straightforward diagnostic tests, such as the EKG or blood chemistry panel, radiological imaging tests are highly variable and complex, often yielding uncertain results, as well as frequent false-negatives and false-positives. The experts who interpret the images (the diagnostic radiologists) sometimes make mistakes: the practice of diagnostic radiology is a fallible, human endeavour, one involving complex perceptual, neuro-physiological and cognitive processes employed under a wide range of circumstances, and with a great deal of variability. Error and Uncertainty in Diagnostic Radiology opens the 'black box,' of medical imaging, exposing the remarkable inner workings of the process of diagnostic radiology-including how and why it can sometimes go tragically wrong. The occurrence of radiological error is shown to be fundamentally intertwined with the underlying high level of uncertainty known to be present in the diagnostic process. As a foremost expert on radiology quality and safety, Dr. Bruno provides insight into the various types of radiologist error, along with a conceptual framework for understanding error and uncertainty in radiology, leading to practical strategies for error prevention and for reducing the risk of harm to patients when errors inevitably occur. This book is essential for radiologists, members of the Society to Improve Diagnosis in Medicine, emergency physicians, medical educators, medical and hospice administrators, especially quality and safety officers, as well as malpractice insurance carriers.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. As the number of malpractice cases continues to grow, radiologists will become increasingly involved in litigation. The aetiology of radiological error is multi-factorial. This book focuses on (1) some medico-legal aspects inherent to radiology (radiation exposure related to imaging procedures and malpractice issues related to contrast media administration are discussed in detail) and on (2) the spectrum of diagnostic errors in radiology. Communication issues between the radiologists and physicians and between the radiologists and patients are also presented. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation.

This is the first book to explore the epistemology and ethics of advanced imaging tests, in order to improve the critical understanding of the nature of knowledge they provide and the practical consequences of their utilization in healthcare. Advanced medical imaging tests, such as PET and MRI, have gained center stage in medical research and in patients’ care. They also increasingly raise questions that pertain to philosophy: What is required to be an expert in reading images? How are standards for interpretation to be fixed? Is there a problem of overutilization of such tests? How should uncertainty be communicated to patients? How to cope with incidental findings? This book is of interest and importance to scholars of philosophy of medicine at all levels, from undergraduates to researchers, to medical researchers and practitioners (radiologists and nuclear physicians) interested in a critical appraisal of the methodology of their discipline and in the ethical principles and consequences of their work.

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.