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Diagnostic error in medicine: analysis of 583 physician-reported errors
Gordon D Schiff1, Omar Hasan, Seijeoung Kim
1Division of General Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont St, Third Floor, Boston, MA 02120, USA. gschiff@partners.org
Archives of Internal Medicine
|November 11, 2009
Summary
Clinicians frequently identified diagnostic errors, particularly in testing and assessment phases. Analyzing these cases reveals patterns to improve patient safety and prevent future diagnostic failures.
Area of Science:
- Patient Safety
- Medical Diagnostics
- Healthcare Quality Improvement
Background:
- Missed or delayed diagnoses represent a significant, yet under-researched, aspect of patient safety.
- Understanding the nuances of diagnostic errors is crucial for enhancing patient care outcomes.
Purpose of the Study:
- To investigate the types, causes, and potential prevention strategies for missed or delayed diagnoses.
- To gather clinician-reported data on diagnostic errors to identify systemic issues.
Main Methods:
- A 6-item survey was distributed to 310 clinicians across 22 institutions in the United States.
- Respondents reported 583 cases of diagnostic errors, detailing causes, severity, and frequency.
Main Results:
- Commonly missed or delayed diagnoses included pulmonary embolism, drug reactions, lung cancer, colorectal cancer, acute coronary syndrome, breast cancer, and stroke.
- Diagnostic errors most frequently occurred during the testing phase (44%) and clinician assessment (32%).
- A significant proportion of errors were rated as major (28%) or moderate (41%) in severity.
Conclusions:
- Physicians are willing to share experiences with diagnostic errors, providing valuable insights.
- Analysis of aggregated diagnostic error cases can reveal patterns and suggest targeted improvement strategies.
- Systematic collection and analysis of diagnostic errors are essential for developing effective preventive measures.
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