Evidence-based team intervention to reduce diagnostic errors in anaemia and CKD diagnoses in primary care: protocol...

Area of Science:

• Primary Care Medicine
• Diagnostic Safety
• Health Services Research

Background:

• Diagnostic errors in primary care are prevalent, especially with abnormal haemoglobin (Hgb) and estimated glomerular filtration rate (eGFR) results.
• These errors often lead to delayed diagnoses of serious conditions like anaemia and chronic kidney disease.
• A novel team-based intervention protocol is proposed to enhance diagnostic safety and efficiency.

Purpose of the Study:

• To evaluate a novel, evidence-based, team-based intervention designed to improve diagnostic safety and efficiency in primary care.
• To assess the impact of the intervention on the timely and accurate diagnosis of conditions related to abnormal Hgb and eGFR.
• To explore implementation metrics, cost-effectiveness, and patient activation.

Main Methods:

• A stepped-wedge cluster randomised controlled trial across 12 University of Texas Physicians primary care clinics.
• Inclusion of adult patients (≥18 years) with newly identified abnormal Hgb or eGFR results.
• Intervention components include automated result tracking, nurse navigators, and clinical pathologist guidance.

Main Results:

• Primary outcome: diagnostic safety, measured by the proportion of patients correctly diagnosed within 6 months.
• Secondary outcomes: diagnostic efficiency, appropriate test utilization, cost-effectiveness, patient activation, and implementation metrics.
• Mixed-methods evaluation to explore implementation barriers and facilitators.

Conclusions:

• The study protocol outlines a rigorous trial to address critical diagnostic errors in primary care.
• Findings are expected to inform potential system-wide implementation of the intervention.
• Dissemination through publications and presentations will share results with the scientific community and healthcare leadership.