Impact of Patient Photos on Detection Accuracy, Decision Confidence and Eye-Tracking Parameters in Chest and Abdomen Images with Tubes and Lines

To minimize errors in imaging studies, a camera system was developed that acquires images of patients simultaneously with radiographic images. Thirty-seven chest/abdomen portable radiographs showing central lines, orogastric/nasogastric/endotracheal tubes with patient photographs were viewed by six radiologists while eye-position was recorded. They indicated whether each line/tube was present/absent and rated confidence. Images were shown in three conditions: radiograph only, small, or large photograph with radiograph. There was greater accuracy in detecting tubes with photographs present and decision confidence was generally higher with the photographs. For the eye-tracking parameters, total viewing time, number of fixations, and number of times observers transferred viewing from radiograph to photograph differed as function of whether a photograph was present or absent as well as photograph size. Adding patient photographs to radiographic interpretation of chest and abdomen films can aid in the detection of tubes/lines. If photograph size is large enough, it takes an average of only 3 extra seconds to view compared to the radiograph alone and adds significant confidence to decisions.

Systemic Error in Radiology

OBJECTIVE

Interpretive errors in diagnostic imaging result in significant patient morbidity and mortality, but the importance of errors and process failures in the imaging cycle other than during image interpretation is underappreciated. In this article, we describe these errors and potential solutions, providing a framework to improve patient safety and understand the changing roles of radiologists beyond image interpretation.

CONCLUSION

For comprehensive improvements to health care delivery, other failures in the cycle besides diagnostic interpretive error-such as ordering inappropriate studies, PACS failures, and a lack of accurate clinician contact information (with resultant communication failure)-should be recognized as contributors to patient harm because they lead to wasted resources and delayed care. By taking ownership of the entire imaging cycle, radiologists can increase their net worth to patient care and cement their roles as experts in the effective, evidence-based use of imaging technologies.