News | Radiology Business | January 12, 2017

MRI imaging referrals often based on cost, not quality, leading to errors

MRI, imaging diagnostic error rates, lower back, The Spine Journal, Hospital for Special Surgery study

January 12, 2017 — A new clinical study published Dec. 20, 2016, in The Spine Journal reveals significant variability in provider quality as well as imaging diagnostic error rates considerably higher than previously reported in the literature.1

In the study, conducted by the Hospital for Special Surgery (HSS) and funded by Spreemo Health's Quality Research Institute (QRI), a single patient was sent for a lower-back magnetic resonance imaging (MRI) scan at 10 different imaging centers over a three-week period. Notably, not a single diagnostic finding — out of 49 distinct findings reported — was identified by all 10 participating centers.

"Diagnostic errors are a well-known problem within the radiological community," said primary author Richard Herzog, M.D., director of spinal imaging at HSS and executive director of Spreemo Health's QRI. "This study reveals the magnitude of that issue for the first time, clearly demonstrating the importance of diagnostic quality for patients and payers."

Peter J. Moley, M.D., assistant attending physiatrist at HSS and a coauthor of the study, noted that variability in the quality of MRI interpretation could yield profoundly different treatment recommendations for the very same patient. "For this patient, recommendations could range from physical therapy to surgery, which shows inter-provider variability is not just an academic problem," said Moley. "It has real-world consequences for patients: An incorrect diagnosis can lead to misdirected therapies, complications and increased disability. This study underscores the need for better standards of diagnostic quality."

For more information: www.thespinejournalonline.com

References

1. Herzog, R., Elgort, D.R., Flanders, A.E., Moley, P.J. "Variability in diagnostic error rates of 10 MRI centers performing lumbar spine MRI examinations on the same patient within a 3-week period," The Spine Journal. Published online Nov. 17, 2016. http://dx.doi.org/10.1016/j.spinee.2016.11.009


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