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Diagnostic Error in the Critically Ill: A Hidden Epidemic?

Paul A Bergl1, Yan Zhou2

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Summary

Diagnostic errors in intensive care units (ICUs) occur in 5-10% of cases, primarily identified through autopsy studies. While the frequency is understood, more research is needed on risk factors.

Keywords:
AutopsyDiagnostic errorIntensive care unitsMedical errorsPatient harmPatient safety

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Area of Science:

  • Critical Care Medicine
  • Medical Error Research
  • Epidemiology

Background:

  • Diagnostic error is a significant concern in intensive care units (ICUs).
  • Existing epidemiologic studies predominantly rely on autopsy series to estimate error rates.
  • Recent advancements in retrospective error measurement methods have refined our understanding.

Purpose of the Study:

  • To summarize current knowledge on the frequency of diagnostic error in the ICU.
  • To highlight the need for further research into risk factors associated with ICU diagnostic errors.

Main Methods:

  • Review of existing epidemiologic studies, primarily descriptive autopsy series.
  • Inclusion of recently validated retrospective methods for error assessment.

Main Results:

  • Diagnostic error rates in the ICU are consistently estimated between 5% and 10%.
  • Both traditional autopsy studies and newer retrospective methods yield similar frequency estimates.
  • The frequency of diagnostic errors in ICUs is relatively well-established.

Conclusions:

  • The prevalence of diagnostic errors in intensive care settings is approximately 5-10%.
  • While the frequency is known, identifying specific risk factors for these errors requires further investigation.