A causal loop approach to the study of diagnostic errors

Missed, wrong or delayed diagnosis has a direct effect on patient safety. Diagnostic errors have been discussed at length, however it still lacks a systematic approach. This study proposed a more systematic way of studying diagnostic errors by using a causal loop diagram. A systematic review was used to find the key factors which may cause diagnostic errors and their interrelationships. A causal loop diagram, as a qualitative model at the first stage of system dynamics modeling, was produced to map all the factor and interrelationships. The diagram provides not only the direct and indirect factors affecting correct diagnosis, but also a clear view of how the change of one factor in the model triggers changes of other factors and then the change of the number of final diagnostic errors.