Error and Discrepancy in Ultrasound Reporting by Sonographers: Inevitable or Negligence

Background: Errors and discrepancies in ultrasound reporting have significant implications for diagnostic accuracy, patient safety, and medico-legal accountability. Literature is awash with radiologists’ quality audits that are aimed at alleviating these errors and discrepancies by radiologists. However, a growing body of evidence suggests increasing responsibilities by sonographers, particularly in under-resourced clinical environments yet there remains a paucity of research regarding quality audits on the conduct of sonographers. Objective: The objective of this study was to explore the nature, frequency, causes, and consequences of diagnostic errors by sonographers in ultrasound reporting. This was in order to determine whether these discrepancies are inevitable outcomes of perceptual limitations or avoidable instances of professional negligence. Methods: A qualitative systematic literature review methodology was adopted using databases including PubMed, ScienceDirect, Web of Science, MEDLINE, and Google Scholar for studies published between 2010 and 2020. Boolean operators and specific keywords such as “errors,” “discrepancies,” “sonographer,” “malpractice,” and “negligence” guided the selection process. Out of 947 initially identified articles, 38 met the inclusion criteria following a PRISMA-guided screening. Thematic synthesis and frequency statistics were employed to analyse recurrent patterns and diagnostic discrepancies. Results: The most prevalent error identified was under-reading or missed findings (18%), followed by lack of knowledge (11%), satisfaction-of-search bias (11%), Poor examination (11%), and satisfaction of report (11%). Systemic issues including sub-optimal workflows, poor access to clinical histories, and inadequate induction training emerged as predominant causes, accounting for 21% of reported discrepancies. Only 17% of the reviewed literature explicitly attributed errors to negligence. Conclusion: The findings suggest that most sonographer errors are perceptual and system-related rather than intentional acts of negligence. Policy reforms focusing on institutional support, standardised protocols, and targeted training initiatives are essential to reduce discrepancies and enhance diagnostic accuracy in ultrasound reporting.