PubMed · 11000196
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D Balsam. 2000. Malpractice: avoiding alliteration.. https://doi.org/10.2214/ajr.175.4.1751191b
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The year 2000 saw a dramatic increase in the incidence of measles infections in Ireland, with >1500 cases documented. Initial cases were reported from an area of Dublin with low vaccine uptake and a large immigrant population. Molecular epidemiologic findings revealed that the strain of measles virus responsible for this outbreak was the genotype D2 strain, which is closely related to strains initially identified in South Africa. It is suggested that suboptimal vaccine uptake facilitated the spread of imported measles infection.
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The interpretation of imaging studies is associated with missed diagnoses. These are due to the inherent limitations of the technique, which are quantified in the sensitivity and specificity of the test and can be caused by normal variation in the interpretation. This can be studied in the reproducibility. Another source of missed diagnoses is related to the observer and is the result of an inadequate technique, mistakes in perception and judgement, and a lack of knowledge. Here, perception error is probably the most important category. A reproachable error is made when a group of experts states that the error should not have been made. Some basic questions that can be posed to reach a judgement in such cases are: was the work conducted in accordance with a protocol, how were the films read and what was the clinical context? The missing of an abnormality on a film can only be judged against the background of the diagnostic handling around such a clinical problem and the quality of the observer.