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The incidence of diagnostic error in medicine

A wide variety of research studies suggest that breakdowns in the diagnostic process result in a staggering toll of harm and patient deaths. These include autopsy studies, case reviews, surveys of patient and physicians, voluntary reporting systems, using standardised patients, second reviews, diagn...

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Detalles Bibliográficos
Autor principal: Graber, Mark L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3786666/
https://www.ncbi.nlm.nih.gov/pubmed/23771902
http://dx.doi.org/10.1136/bmjqs-2012-001615
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author Graber, Mark L
author_facet Graber, Mark L
author_sort Graber, Mark L
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description A wide variety of research studies suggest that breakdowns in the diagnostic process result in a staggering toll of harm and patient deaths. These include autopsy studies, case reviews, surveys of patient and physicians, voluntary reporting systems, using standardised patients, second reviews, diagnostic testing audits and closed claims reviews. Although these different approaches provide important information and unique insights regarding diagnostic errors, each has limitations and none is well suited to establishing the incidence of diagnostic error in actual practice, or the aggregate rate of error and harm. We argue that being able to measure the incidence of diagnostic error is essential to enable research studies on diagnostic error, and to initiate quality improvement projects aimed at reducing the risk of error and harm. Three approaches appear most promising in this regard: (1) using ‘trigger tools’ to identify from electronic health records cases at high risk for diagnostic error; (2) using standardised patients (secret shoppers) to study the rate of error in practice; (3) encouraging both patients and physicians to voluntarily report errors they encounter, and facilitating this process.
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spelling pubmed-37866662013-10-01 The incidence of diagnostic error in medicine Graber, Mark L BMJ Qual Saf Narrative Review A wide variety of research studies suggest that breakdowns in the diagnostic process result in a staggering toll of harm and patient deaths. These include autopsy studies, case reviews, surveys of patient and physicians, voluntary reporting systems, using standardised patients, second reviews, diagnostic testing audits and closed claims reviews. Although these different approaches provide important information and unique insights regarding diagnostic errors, each has limitations and none is well suited to establishing the incidence of diagnostic error in actual practice, or the aggregate rate of error and harm. We argue that being able to measure the incidence of diagnostic error is essential to enable research studies on diagnostic error, and to initiate quality improvement projects aimed at reducing the risk of error and harm. Three approaches appear most promising in this regard: (1) using ‘trigger tools’ to identify from electronic health records cases at high risk for diagnostic error; (2) using standardised patients (secret shoppers) to study the rate of error in practice; (3) encouraging both patients and physicians to voluntarily report errors they encounter, and facilitating this process. BMJ Publishing Group 2013-10 2013-06-15 /pmc/articles/PMC3786666/ /pubmed/23771902 http://dx.doi.org/10.1136/bmjqs-2012-001615 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions this is an open access article distributed in accordance with the creative commons attribution non commercial (cc by-nc 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. see: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Narrative Review
Graber, Mark L
The incidence of diagnostic error in medicine
title The incidence of diagnostic error in medicine
title_full The incidence of diagnostic error in medicine
title_fullStr The incidence of diagnostic error in medicine
title_full_unstemmed The incidence of diagnostic error in medicine
title_short The incidence of diagnostic error in medicine
title_sort incidence of diagnostic error in medicine
topic Narrative Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3786666/
https://www.ncbi.nlm.nih.gov/pubmed/23771902
http://dx.doi.org/10.1136/bmjqs-2012-001615
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