@article{12380,
  author = {John C. Matulis and Susan N Kok and Eugene C Dankbar and Andrew J Majka},
  title = {A survey of outpatient Internal Medicine clinician perceptions of diagnostic error},
  abstract = {<jats:title>Abstract</jats:title>
               <jats:sec id="j_dx-2019-0070_s_999_w2aab3b7c18b1b6b1aab1c17b1Aa">
                  <jats:title>Background</jats:title>
                  <jats:p>Little is known about how practicing Internal Medicine (IM) clinicians perceive diagnostic error, and whether perceptions are in agreement with the published literature.</jats:p>
               </jats:sec>
               <jats:sec id="j_dx-2019-0070_s_998_w2aab3b7c18b1b6b1aab1c17b2Aa">
                  <jats:title>Methods</jats:title>
                  <jats:p>A 16-question survey was administered across two IM practices: one a referral practice providing care for patients traveling for a second opinion and the other a traditional community-based primary care practice. Our aim was to identify individual- and system-level factors contributing to diagnostic error (primary outcome) and conditions at greatest risk of diagnostic error (secondary outcome).</jats:p>
               </jats:sec>
               <jats:sec id="j_dx-2019-0070_s_997_w2aab3b7c18b1b6b1aab1c17b3Aa">
                  <jats:title>Results</jats:title>
                  <jats:p>Sixty-five of 125 clinicians surveyed (51%) responded. The most commonly perceived individual factors contributing to diagnostic error included atypical patient presentations (83%), failure to consider other diagnoses (63%) and inadequate follow-up of test results (53%). The most commonly cited system-level factors included cognitive burden created by the volume of data in the electronic health record (EHR) (68%), lack of time to think (64%) and systems that do not support collaboration (40%). Conditions felt to be at greatest risk of diagnostic error included cancer (46%), pulmonary embolism (43%) and infection (37%).</jats:p>
               </jats:sec>
               <jats:sec id="j_dx-2019-0070_s_996_w2aab3b7c18b1b6b1aab1c17b4Aa">
                  <jats:title>Conclusions</jats:title>
                  <jats:p>Inadequate clinician time and sub-optimal patient and test follow-up are perceived by IM clinicians to be persistent contributors to diagnostic error. Clinician perceptions of conditions at greatest risk of diagnostic error may differ from the published literature.</jats:p>
               </jats:sec>},
  year = {2020},
  journal = {Diagnosis},
  volume = {7},
  pages = {107-114},
  month = {01/2020},
  publisher = {Walter de Gruyter GmbH},
  issn = {2194-802X},
  doi = {10.1515/dx-2019-0070},
}