Inattentional blindness in radiology: a concise checklist approach

Abstract

Inattentional blindness has been identified as a partial cause for missed diagnoses among radiologists. Missed findings present a significant challenge as they can have clinical implications for patients. This study investigated the effectiveness of a four-item concise medical checklist in reducing inattentional blindness among radiologists when interpreting chest computed tomography (CT) scans. Thirty-two radiologists participated in the study: an experimental group (with the checklist, n = 18) and a control group (no checklist, n = 14). Participants were instructed to read seven chest CT stacks (one practice case and six experimental cases), and to mark all lung nodules ≥3 mm. In the final CT stack, a breast cancer mass and lymphadenopathy served as the inattentional blindness stimuli. Lung nodule detection was marginally higher in the control group (62%) than in the experimental group (55%), but this difference was not statistically significant. Almost 80% of radiologists in both groups failed to report the breast cancer mass, whilst lymphadenopathy identification was at chance level in both the control (50%) and experimental (58%) groups. Group comparisons for both analyses were also non-significant. These findings suggest that a concise medical checklist may not be an effective solution to mitigate inattentional blindness among radiologists when interpreting chest CT scans. Further research and alternative approaches are warranted to address diagnostic errors in medical imaging resulting from inattentional blindness.