Is work overload associated with diagnostic errors on 18F-FDG-PET/CT?

Abstract

Purpose: To determine the association between workload and diagnostic errors on ¹⁸F-FDG-PET/CT.

Materials and methods: This study included 103 ¹⁸F-FDG-PET/CT scans with a diagnostic error that was corrected with an addendum between March 2018 and July 2023. All scans were performed at a tertiary care center. The workload of each nuclear medicine physician or radiologist who authorized the ¹⁸F-FDG-PET/CT report was determined on the day the diagnostic error was made and normalized for his or her own average daily production (workload_normalized). A workload_normalized of more than 100% indicates that the nuclear medicine physician or radiologist had a relative work overload, while a value of less than 100% indicates a relative work underload on the day the diagnostic error was made. The time of the day the diagnostic error was made was also recorded. Workload_normalized was compared to 100% using a signed rank sum test, with the hypothesis that it would significantly exceed 100%. A Mann-Kendall test was performed to test the hypothesis that diagnostic errors would increase over the course of the day.

Results: Workload_normalized (median of 121%, interquartile range: 71 to 146%) on the days the diagnostic errors were made was significantly higher than 100% (P = 0.014). There was no significant upward trend in the frequency of diagnostic errors over the course of the day (Mann-Kendall tau = 0.05, P = 0.7294).

Conclusion: Work overload seems to be associated with diagnostic errors on ¹⁸F-FDG-PET/CT. Diagnostic errors were encountered throughout the entire working day, without any upward trend towards the end of the day.

Keywords: 18F-FDG; Computed tomography; Diagnostic errors; PET-CT; Workload.