HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: 2222011000v1 222/2/301    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Friedenberg, R. M. Search for Related Content PubMed Articles by Friedenberg, R. M.

Commentary on The Tyranny of Accuracy in Radiologic Education¹

¹ From the Department of Radiological Sciences, University of California, Irvine Medical Center, Orange. Received June 6, 2001; accepted June 7. Address correspondence to the author, 18961 Castlegate Ln, Santa Ana, CA 92705 (e-mail: rmfriede@uci.edu).

Index terms: Education • Perspectives • Radiology and radiologists

Gunderman and Nyce (1), in the current issue of Radiology, use the word accuracy in a dictionary manner to mean the quality of being true, correct, or exact. Medicine, which is a science dealing largely with uncertainty in diagnosis and with multiple differential possibilities, certainly has a problem with the dictionary definition of accuracy. There is nothing to disagree with in the article by Gunderman and Nyce (1) except perhaps their concept of how we use accuracy in radiology. Certainly their statement that "radiologists need to be not only accurate but also relevant" reflects a thought we have tried to instill in our residents for generations. We try to teach residents that in radiology there really is no normal finding but only the absence of a substantial abnormality.

Radiology reports are always influenced by the patient’s medical history and physical and laboratory data. The same chest radiograph can be interpreted differently depending on the data provided. The radiology report is a consultation and, as such, should consider any and all relevant material that can help in providing aid to the patient and the physician. This would include the proper follow-up examination if pertinent, the differential diagnosis, and also answers to any questions posed by the referring physician. Therefore, I believe that a loose definition of accuracy in the radiologic field encompasses more than a diagnosis but is in effect a consultation. I believe that all teachers of radiology try to convey this to their residents.

In our current managed care computerized environment, with constant pressure to increase the number of cases reviewed by each radiologist, institutions may use short one-line or even "canned" reports, which may omit findings that might contribute to the diagnosis in a patient. Residents no longer spend sufficient time with their mentors to learn how to properly report.

Perhaps a more pertinent question would be the following: How do we teach residents today, in the competitive atmosphere that has developed in our academic centers, to deal with the inevitable problem of uncertainty in medical diagnosis as they review and report each case? This would be an interesting topic for Gunderman and Nyce to consider.

FOOTNOTES

See also the article by Gunderman and Nyce (pp 297–300 ) in this issue.

REFERENCES

1. Gunderman RB, Nyce JM. The tyranny of accuracy in radiologic education. Radiology 2002; 222:297-300.[Free Full Text]

This Article Full Text (PDF) All Versions of this Article: 2222011000v1 222/2/301    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Friedenberg, R. M. Search for Related Content PubMed Articles by Friedenberg, R. M.