Batty, R., Gawne-Cain, M., Mooney, C. orcid.org/0000-0002-3086-7348 et al. (4 more authors) (2019) Analysis of errors made on in utero MR studies of the foetal brain in the MERIDIAN study. European Radiology, 29 (1). pp. 195-201. ISSN 0938-7994
Abstract
Objectives In utero Magnetic Resonance (iuMR) imaging to diagnose fetal brain abnormalities has been established and is supported by meta-analyses of retrospective and prospective studies. In this paper we describe and classify the iuMR errors made in the largest diagnostic accuracy study to date (MERIDIAN). We also correlate the error rates and types with the prior experience of the reporting radiologists in order to inform how to provide a national programme with the best diagnostic accuracy achievable. Methods The MERIDIAN cohort of 570 fetuses formed the basis of this study and included 40 cases with a confirmed diagnostic error, compared with the Outcome Reference Diagnosis. Analysis included the potential clinical effect of the error and classification of error type through an Expert Neuroradiological Panel re-reporting the study. Assessments were made regarding radiologists experience prior to MERIDIAN. Results The overall confirmed error rate for iuMR was 7·0% and it was considered that there would have been an adverse effect on prognostic information in 22/40 cases if the iuMR had informed counselling. The experienced central reporter made statistically significant fewer errors than the less experienced non-central reporters (3·8% v 11·0%) and the central reporter made fewer clinically significant errors. Furthermore, the type of cognitive errors differed between central and non-central reporters. Conclusions Although iuMR imaging improves the diagnostic accuracy of detecting fetal brain abnormalities there remains a substantial error rate, which can have major clinical significance. We have shown that error rates are lower for more experienced reporting radiologists with fewer potential deleterious clinical implications. We discuss the implications of these findings in terms of providing a uniform national service.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
Keywords: | Magnetic Resonance; diagnostic errors; radiologists; brain; fetus |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Funding Information: | Funder Grant number DEPARTMENT OF HEALTH 09/06/01 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 23 Apr 2018 15:24 |
Last Modified: | 17 Nov 2020 12:22 |
Status: | Published |
Publisher: | Springer Verlag |
Refereed: | Yes |
Identification Number: | 10.1007/s00330-018-5508-x |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:129838 |
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