Anatomical side markers – a future vision for a perennial problem.

Abstract

This proposal introduces a simple, innovative, cost‐effective and error reducing solution to the ongoing problem of image mislabelling and its associated life threatening and medico‐legal consequences. Published audits have shown that missing or incorrect side marker events can occur in nearly 6% of medical images acquired, and in some more acute scenarios may exceed 50%.2 Most attempts to reduce these rates focus on further training and auditing, but can realistically only hope to achieve incremental improvements while human fallibility remains a factor. The introduction of a digital photographic image acquired simultaneously and archived with the medical image could provide widespread benefits including unequivocal side and position identification, eliminating the risk of human error. This concept could be easily applied across all modalities where side specificity and patient orientation is of concern. Multiple additional advantages include time and dose saving benefits through reduction in retakes and improved follow‐up reproducibility of images. It could also become an invaluable education and teaching tool, leading to improved radiology reporting accuracy (with an increase in available clinical information and patient identifiers) plus improve accuracy in forensic applications. A literature search revealed prior implementation and application of the same basic concept, though primarily focussing on patient identification rather than the potential elimination of side and orientation marker errors. This indicates that further study is required regarding the potential benefits in error elimination. Discussion regarding the feasible implementation of this simple technology, and the case for its mandatory inclusion into all imaging equipment, is raised.