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Process of care failures in breast cancer diagnosis.
Weingart SN, Saadeh MG, Simchowitz B, et al. J Gen Intern Med. 2009;24:702-709.

Diagnostic errors have been described as the next frontier in patient safety, with past studies discussing their epidemiology and the contributing role of physician overconfidence. This retrospective chart review analyzed cases of recently diagnosed breast cancer to identify patient- and provider-related process of care failures. Investigators targeted those cases where a delay of at least 90 days occurred between symptom onset and diagnosis and found a high rate of process failures. These were attributed to both providers for failing to perform adequate physical exams and patients for failing to undergo recommended tests, as two examples. Missed or delayed cancer diagnoses are a frequent cause of malpractice lawsuits, and errors in cancer diagnosis are also a noted challenge. The authors advocate for the importance of educating and empowering patients as an additional strategy to improve the quality of care.

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