The Mask Effect: More, but Minor, Radiology Report Dictation Errors

Wearing a surgical mask while using speech recognition to complete a radiology report does lead to a higher dictation error rate – but, don’t worry. Most mistakes are minor are unlikely to negatively impact care.

Masks have become a necessary and ubiquitous part of healthcare throughout the COVID-19 pandemic, and some in the industry have worried that wearing a mask while using speech-recognition software could open the door for unintended errors.

In a poster presented during the Society for Imaging Informatics in Medicine (SIIM) 2021 Virtual Annual Meeting, Abiola Femi-Abodunde, M.D., a diagnostic radiology resident from the University of North Carolina at Chapel Hill School of Medicine, revealed that masks do cause a 25-percent increase is dictation errors, but they’re small.

“There is a near-significant increase in the rate of dictation errors in unedited radiologist reports created with speech-recognition software, a difference which may be accentuated in some groups of radiologists,” she said. “However, most errors are minor single-word errors and are unlikely to result in a medically relevant misunderstanding.”

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For this study, the team created 40 model radiology reports that simulated radiographic/fluoroscopic, ultrasound, CT, and MRI imaging reports that are typically captured in academic medical centers. Six radiologists, who were randomly assigned to masked and unmasked groups, used speech-recognition software to dictate those reports. Their versions were, then, compared to the models, and the team classified any errors by type and severity.

According to their analysis, the overall dictation error rate was 25-percent higher when radiologists wore masks. Specifically, masked providers made 27.1 +/- 2.2 errors per 1,000 words compared with the 21.7 +/- 4.9 errors per 1,000 words from unmasked providers. But, after excluding one trainee with an accented speech pattern, the overall error rate fell to a 19-percent increase while masked – 20.1 +/- 2.2 errors per 1,000 words during masking and 16.9 +/- 1.9 errors per 1,000 words unmasked. Of the unmasked errors, she said, 58 percent were minor, as were 56 percent of those occurring while masked.

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