Common Anomalies

Introduction

If the Accession Number or Patient ID that is transmitted to Synapse from the imaging modalities through DICOM server is incorrect, matching errors can occur.

Incorrect ID Categories

Incorrect ID numbers fall into two categories.

• First category: An incorrect ID number can match an ID that currently exists in the Synapse database.
  For example, a Patient ID that is entered incorrectly at the modality can match a different patient’s ID number in Synapse.
• Second category: An incorrect ID number can be currently unique.
  For example, an accession # that is entered incorrectly at the modality can be currently unique.

These two event categories cause two types of anomaly:

• Mismatch anomaly - When an incorrect ID number matches an existing ID number for a different patient in Synapse, a mismatch anomaly occurs. In a mismatch anomaly, Synapse inserts images or studies into an incorrect folder.
• New Patient or New Study anomaly - When an incorrect ID number is currently unique (does not currently match anything in the Synapse database), a New Patient or New Study anomaly occurs. This anomaly indicates that Synapse has created a duplicate patient or study folder in the database.

Major Causes of Anomalies

The following four scenarios represent the major causes, and results, of Synapse anomalies:

1. Patient ID – Correct; Accession Number – Correct
   1. Effect: Synapse correctly inserts images into correct study folder
   2. Anomaly: None
   3. Correction: None
2. Patient ID – Incorrect; Accession Number – Correct
   1. Incorrect Patient ID matches an existing Patient ID
      1. Effect: Synapse correctly inserts images into correct study folder, based on Accession Number
      2. Anomaly: Mismatch
      3. Correction: None, false positive
         1. Source=Mismatched images or series, located in incorrect study folder
         2. Destination=Correct study folder
   2. Incorrect Patient ID is currently unique
      1. Effect: Synapse correctly inserts images into correct study folder, based on Accession Number
      2. Anomaly: Mismatch
      3. Correction: None, false positive because Study is correctly matched based on Accession Number
3. Patient ID – Correct; Accession Number – Incorrect
   1. Incorrect Accession Number matches an existing Accession Number
      1. Effect: Synapse inserts images into incorrect study folder based on incorrect Accession Number
      2. Anomalies:
         1. Study Reset or Study Not Reset
         2. Mismatch [Patient ID]
         3. Mismatch [Patient Name]
      3. Correction: Image or Series Reallocation
   2. Incorrect Accession Number is currently unique
      1. Effect: Synapse creates new (duplicate) study folder in the correct patient folder and inserts images
      2. Anomaly: Study Absent
      3. Correction: Study Merge
         1. Source=New study folder (with images)
         2. Destination=Correct study folder
4. Patient ID – Incorrect; Accession Number – Incorrect
   1. Incorrect Patient ID matches an existing Patient ID; Incorrect Accession Number matches an existing Accession Number
      1. Effect: Synapse inserts images into incorrect study folder, based on incorrect Accession Number
      2. Anomalies:
         1. Study Reset or Study Not Reset
         2. Mismatch [Patient ID]
         3. Mismatch [Patient Name]
      3. Correction: Image or Series Reallocation
         1. Source=Mismatched images or series, located in incorrect study folder
         2. Destination=Correct study folder
   2. Incorrect Patient ID matches an existing Patient ID; Incorrect Accession Number is currently unique
      1. Effect: Synapse creates new (duplicate) study folder in the incorrect patient folder
      2. Anomaly: Study Absent
      3. Correction: Study Merge
         1. Source=New study folder (in incorrect patient folder)
         2. Destination=Correct study folder
   3. Incorrect Patient ID is currently unique; Incorrect Accession Number matches an existing Accession Number
      1. Effect: Synapse inserts images into incorrect study folder, based on incorrect Accession Number
      2. Anomalies:
         1. Study Reset or Study Not Reset
         2. Mismatch [Patient ID]
         3. Mismatch [Patient Name]
      3. Correction: Image or Series Reallocation
         1. Source=Mismatched images or series, located in incorrect study folder
         2. Destination=Correct study folder
   4. Incorrect Patient ID is currently unique; Incorrect Accession Number is currently unique
      1. Effect: Synapse creates a new (duplicate) patient folder and a new (duplicate) study folder, inserts images into new study folder
      2. Anomaly: Study Absent
      3. Correction: Patient Merge AND Study Merge
         1. Patient Merge Source=New patient folder
         2. Patient Merge Destination=Correct patient folder
         3. Study Merge Source=New study folder (now in correct patient folder)
         4. Study Merge Destination=Correct patient folder