Related Experiment Video

Updated: Jan 8, 2026

Author Spotlight: Advancing Pathogen Detection and Disease Assessment in Real-Time Using M-ROSE
03:22

Author Spotlight: Advancing Pathogen Detection and Disease Assessment in Real-Time Using M-ROSE

Published on: March 1, 2024

800

Suboptimal Diagnostic Decisions In Hospitalized Patients with Fever: A Prospective Record Review with Physician

Jacky Hooftman, Jonne J Sikkens, Nienke van Wingerden

    Joint Commission Journal on Quality and Patient Safety
    |December 20, 2025
    PubMed
    Abstract

    Insights

    Suboptimal diagnostic decisions in hospitalized patients correlate with increased diagnostic error and discrepancy. However, these measures of diagnostic safety appear distinct and require separate consideration in future research.

    Area of Science:

    • Medical diagnostics
    • Patient safety
    • Clinical decision-making

    Background:

    • The complexity of medical diagnosis can lead to suboptimal decision-making.
    • The relationship between suboptimal diagnostic decisions, diagnostic error, and diagnostic discrepancy is not well understood.

    Purpose of the Study:

    • To investigate the relationship between suboptimal diagnostic decisions and other measures of diagnostic safety, including diagnostic error and diagnostic discrepancy.
    • To explore the overlap and distinctions between these concepts in hospitalized patients.

    Main Methods:

    • Prospective study of 53 hospitalized patients with fever.
    • Independent physician review of medical records to identify suboptimal decisions and errors.
    • Physician interviews to understand decision-making processes.
    • Utilized established tools for categorization of diagnostic safety measures.

    Main Results:

    • 71.7% of cases initially showed suboptimal diagnostic decisions, reduced to 54.7% after interviews.
    • A higher number of suboptimal decisions correlated with increased diagnostic error and discrepancy.
    • No significant association was found between diagnostic error and diagnostic discrepancy.
    • Most suboptimal decisions were human-related, occurring during patient assessment and testing.

    Conclusions:

    • Suboptimal diagnostic decisions are linked to higher rates of diagnostic error and discrepancy.
    • These diagnostic safety measures represent distinct concepts with limited overlap.
    • Future research should integrate physician interviews to capture contextual factors influencing diagnostic safety.

    Related Concept Videos

    Documentation of Nursing Diagnosis01:10

    Documentation of Nursing Diagnosis

    The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
    In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
    1.6K
    Methods of reducing fever01:22

    Methods of reducing fever

    The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
    Pharmacological Methods of Reducing Fever:
    1.2K
    Patterns of Fever01:26

    Patterns of Fever

    Before understanding the types and patterns of fever, it is essential to know its phases.
    3.7K
    Increased Body Temperature01:25

    Increased Body Temperature

    A body temperature above  38°C  (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in...
    6.3K
    Pneumonia III: Complications and Assessment01:30

    Pneumonia III: Complications and Assessment

    Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
    756
    Acute Pyelonephritis II: Diagnostic Studies and Management01:28

    Acute Pyelonephritis II: Diagnostic Studies and Management

    Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
    285