Veterinary radiologic error rate as determined by necropsy

Jonathan Cohen, Anthony J. Fischetti, Heather Daverio

Background: The authors conducted a retrospective study to evaluate the radiologic error rate and the sources of discrepancy between antemortem imaging and postmortem necropsy in veterinary medicine.

Study: The authors collected 131 cases from a veterinary teaching hospital that had both imaging and necropsy reports within a 1-year period. They compared the radiologic and pathologic diagnoses and categorized them as correct, discrepant, or error. They also classified the diagnoses as major or minor based on their clinical significance.

Methods: The authors used descriptive categories and criteria adapted from previous studies in human medicine to assess the radiologic–pathologic agreement and discrepancy. They also calculated the major discrepancy rate and the radiologic error rate using formulas derived from Murken’s study. They identified the most common sources of discrepancy and error, and the contributing perceptual and cognitive biases.

Results: The authors found that the major discrepancy rate was 40%, and the radiologic error rate was 4.6%, which were comparable to the rates reported in human medicine. The most common sources of discrepancy were temporal indeterminacy, sensitivity limitation, and study-type limitation. The most common sources of error were framing bias, attribution bias, and satisfaction of search. The organ system most associated with discrepancy was the respiratory tract, and the diagnosis most associated with discrepancy was interstitial lung disease.

Limitations: The authors acknowledged some limitations of their study, such as the small sample size, the single-center design, the lack of blinding, the subjective classification of diagnoses and discrepancies, and the potential confounding factors of clinical management and treatment.

Conclusions: The authors concluded that radiologic error and discrepancy are common in veterinary medicine, and that identifying the patterns and causes of misdiagnosis can help radiologists improve their interpretation skills and reduce diagnostic errors. They also suggested that a multidisciplinary approach involving clinicians, radiologists, and pathologists is essential for accurate diagnosis and optimal patient care.