Disclosing harmful mammography errors to patients

Thomas H. Gallagher, Andrea J. Cook, R. James Brenner, Patricia (Patty) Carney, Diana L. Miglioretti, Berta M. Geller, Karla Kerlikowske, Tracy L. Onega, Robert D. Rosenberg, Bonnie C. Yankaskas, Constance D. Lehman, Joann G. Elmore

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose: To assess radiologists' attitudes about disclosing errors to patients by using a survey with a vignette involving an error interpreting a patient's mammogram, leading to a delayed cancer diagnosis. Materials and Methods: We conducted an institutional review board-approved survey of 364 radiologists at seven geographically distinct Breast Cancer Surveillance Consortium sites that interpreted mammograms from 2005 to 2006. Radiologists received a vignette in which comparison screening mammograms were placed in the wrong order, leading a radiologist to conclude calcifications were decreasing in number when they were actually increasing, delaying a cancer diagnosis. Radiologists were asked (a) how likely they would be to disclose this error, (b) what information they would share, and (c) their malpractice attitudes and experiences. Results: Two hundred forty-three (67%) of 364 radiologists responded to the disclosure vignette questions. Radiologists' responses to whether they would disclose the error included "definitely not" (9%), "only if asked by the patient" (51%), "probably" (26%), and "definitely" (14%). Regarding information they would disclose, 24% would "not say anything further to the patient," 31% would tell the patient that "the calcifications are larger and are now suspicious for cancer," 30% would state "the calcifications may have increased on your last mammogram, but their appearance was not as worrisome as it is now," and 15% would tell the patient "an error occurred during the interpretation of your last mammogram, and the calcifications had actually increased in number, not decreased." Radiologists' malpractice experiences were not consistently associated with their disclosure responses. Conclusion: Many radiologists report reluctance to disclose a hypothetical mammography error that delayed a cancer diagnosis. Strategies should be developed to increase radiologists' comfort communicating with patients.

Original languageEnglish (US)
Pages (from-to)443-452
Number of pages10
JournalRadiology
Volume253
Issue number2
DOIs
StatePublished - Nov 2009
Externally publishedYes

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Mammography
Malpractice
Disclosure
Neoplasms
Radiologists
Research Ethics Committees
Delayed Diagnosis
Breast Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Gallagher, T. H., Cook, A. J., Brenner, R. J., Carney, P. P., Miglioretti, D. L., Geller, B. M., ... Elmore, J. G. (2009). Disclosing harmful mammography errors to patients. Radiology, 253(2), 443-452. https://doi.org/10.1148/radiol.2532082320

Disclosing harmful mammography errors to patients. / Gallagher, Thomas H.; Cook, Andrea J.; Brenner, R. James; Carney, Patricia (Patty); Miglioretti, Diana L.; Geller, Berta M.; Kerlikowske, Karla; Onega, Tracy L.; Rosenberg, Robert D.; Yankaskas, Bonnie C.; Lehman, Constance D.; Elmore, Joann G.

In: Radiology, Vol. 253, No. 2, 11.2009, p. 443-452.

Research output: Contribution to journalArticle

Gallagher, TH, Cook, AJ, Brenner, RJ, Carney, PP, Miglioretti, DL, Geller, BM, Kerlikowske, K, Onega, TL, Rosenberg, RD, Yankaskas, BC, Lehman, CD & Elmore, JG 2009, 'Disclosing harmful mammography errors to patients', Radiology, vol. 253, no. 2, pp. 443-452. https://doi.org/10.1148/radiol.2532082320
Gallagher TH, Cook AJ, Brenner RJ, Carney PP, Miglioretti DL, Geller BM et al. Disclosing harmful mammography errors to patients. Radiology. 2009 Nov;253(2):443-452. https://doi.org/10.1148/radiol.2532082320
Gallagher, Thomas H. ; Cook, Andrea J. ; Brenner, R. James ; Carney, Patricia (Patty) ; Miglioretti, Diana L. ; Geller, Berta M. ; Kerlikowske, Karla ; Onega, Tracy L. ; Rosenberg, Robert D. ; Yankaskas, Bonnie C. ; Lehman, Constance D. ; Elmore, Joann G. / Disclosing harmful mammography errors to patients. In: Radiology. 2009 ; Vol. 253, No. 2. pp. 443-452.
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