How one medical checkup can snowball into a ‘cascade’ of tests, causing more harm than good.

Newspaper/Magazine Article

How one medical checkup can snowball into a ‘cascade’ of tests, causing more harm than good.

January 22, 2020

Ganguli I. Washington Post. January 5, 2020.

View more articles from the same authors.

Overdiagnosis and uncertainty can result in a range of care activities that contribute to financial, emotional and physical harms to patients and families. This story discusses unintended consequences of a medical test and offers suggestions for patients and clinician to reduce the potential for these harms without compromising care.

Free full text

Related Resources From the Same Author(s)

Not ‘just depression.’ She seemed trapped in a downward mental health spiral. The real cause was a profound shock.

February 3, 2021

First, Do No Harm.

September 14, 2011

A doctor gave me an inept diagnosis for a neurological problem. I should know: I’m a neurologist.

October 14, 2020

Spikes in demand from coronavirus patients are creating shortages of asthma drugs and sedatives for ventilator patients.

April 22, 2020

My life was upended for 35 years by a cancer diagnosis. A doctor just told me I was misdiagnosed.

April 7, 2021

A woman’s laborious search uncovered the probable cause of her searing abdominal pain. Getting a doctor to help was much harder.

March 3, 2021

Your diagnosis was wrong. Could doctor bias have been a factor?

December 11, 2019

Suspicious insulin injections, nearly a dozen deaths: inside an unfolding investigation at a VA hospital in West Virginia.

October 23, 2019

Five simple steps to avoid becoming a medical mystery.

December 14, 2016

Rating hospitals by the stars: the feds' latest plan to measure quality is the most controversial.

June 1, 2016

Hospital discharge: it's one of the most dangerous periods for patients.

May 11, 2016

Electronic medicine can send you test results quickly. But what if they're scary?

April 11, 2018

How Veterans Affairs failed to stop a pathologist who misdiagnosed 3,000 cases.

September 11, 2019

From heart disease to IUDs: how doctors dismiss women’s pain.

December 21, 2022

She was headed to a locked psych ward. Then an ER doctor made a startling discovery.

March 2, 2022

To eliminate bias, some seek out doctors of their own race or ethnicity.

December 22, 2021

The other big drug problem: older people taking too many pills.

December 20, 2017

Anger management courses are a new tool for dealing with out-of-control doctors.

March 13, 2013

A silent epidemic.

March 7, 2007

Ambulance crew in Chicago got lost trying to find hospital.

November 7, 2007

Reused devices, surgery's deadly suspects.

January 18, 2006

Hospitals save money, but safety is questioned.

January 4, 2006

Teaming up to prevent 'crashes': some hospitals give patients the power to get extra help, stat.

September 19, 2007

Get me out alive.

May 17, 2006

Cedars-Sinai doctors cling to pen and paper: transition to electronic medical records proves difficult.

April 3, 2005

Medicare study finds teaching hospitals have higher risk of complications; findings disputed.

February 29, 2012

Medical mystery: alcoholism didn’t cause man’s diabetes and cirrhosis.

June 29, 2011

Hospitals tally their avoidable mistakes.

August 5, 2009

The pain of wrong site surgery.

July 6, 2011

Shifting the risks at night.

June 22, 2011

US drug shortages threatening those whose lives depend on crucial remedies.

May 18, 2011

How to seek care for non-covid health issues during the pandemic, and why you shouldn’t delay.

September 29, 2021

Not quite fail-safe: computerizing isn't a panacea for dangerous drug errors, study shows.

April 3, 2005

Actions Needed to Help Ensure Appropriate Medication Continuation and Prescribing Practices.

February 24, 2016

A growing number of primary-care doctors are burning out. How does this affect patients?

April 9, 2014

What a doctor may miss by reaching for the MRI first.

May 28, 2014

Suicides point to gaps in treatment. Errors in psychiatric diagnoses and drugs plague strained immigration system.

May 21, 2008

Deficiencies in Inpatient Mental Health Care Coordination and Processes Prior to a Patient's Death by Suicide, Harry S. Truman Memorial Veterans' Hospital in Columbia, Missouri.

February 10, 2021

A night in the hospital, from both ends of the stethoscope.

January 20, 2021

Half of hospitals in Conn., Del. hit by Medicare's safety penalties.

January 17, 2018

Adverse Events in Hospitals: Public Disclosure of Information About Events.

January 20, 2010

Some health workers suffering from addiction steal drugs meant for patients.

October 21, 2020

Deficiencies in Care Coordination and Facility Response to a Patient Suicide at the Minneapolis VA Health Care System, Minnesota.

January 29, 2020

Cascades of care after incidental findings in a US national survey of physicians.

November 6, 2019

COVID-19 Content. ISMP Medication Safety Alert!

January 14, 2021

Shifting the Mindset: A Closer Look at Hospital Complaints.

March 11, 2020

Artificial intelligence makes bad medicine even worse.

February 5, 2020

Prescription drug overload: critics fighting to curb an epidemic of medication side effects.

January 29, 2020

Mid Staffs scandal: 10 years on, inquiry chair worries NHS staff too scared to speak up.

January 29, 2020

Approaches and Challenges to Electronically Matching Patients' Records Across Providers.

March 6, 2019

How chaos at chain pharmacies is putting patients at risk.

February 19, 2020

Preeminent hospitals penalized over rates of patients’ injuries.

February 19, 2020

The Patient Safety Initiative at America’s Public Hospitals: The Year One Overview.

February 9, 2011

Patient Safety Act.

February 10, 2010

Health Literacy Practices in Primary Care Settings: Examples from the Field.

February 6, 2008

Safety in Numbers: Hospital Performance on Leapfrog’s Surgical Volume Standard Based on Results of the 2019 Leapfrog Hospital Survey.

March 18, 2020

The Care We Need

July 8, 2020

Physician-Owned Specialty Hospital's Ability to Manage Medical Emergencies.

January 23, 2008

Improving Diagnostic Quality and Safety/Reducing Diagnostic Error: Measurement Considerations. Final Report

October 28, 2020

Hospital Incident Reporting Systems Do Not Capture Most Patient Harm.

January 18, 2012

Medicare’s Oversight of Compounded Pharmaceuticals Used in Hospitals.

February 11, 2015

Defense Health Agency Processes for Responding to Provider Quality and Safety Concerns.

December 23, 2020

Diagnostic Safety Toolkit.

May 27, 2020

Trends in Pregnancy-Related Deaths and Federal Efforts to Reduce Them.

April 29, 2020

Patient Safety, Spring 2019 Final CDP Report.

March 25, 2020

Artificial Intelligence in Health Care: Benefits and Challenges of Technologies to Augment Patient Care.

December 9, 2020

Infection Control Deficiencies Were Widespread and Persistent in Nursing Homes Prior to COVID-19 Pandemic.

May 27, 2020

Surveys on Patient Safety Culture (SOPS) Ambulatory Surgery Center Survey: 2020 User Database Report.

March 18, 2020

Incidence of Adverse Events in Indian Health Service Hospitals.

December 23, 2020

Longitudinal medication reconciliation at hospital admission, discharge and post-discharge.

August 26, 2020

Crisis Standards of Care: Ten Years of Successes and Challenges–Proceedings of a Workshop.

May 13, 2020

Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020.

April 22, 2020

My patient almost died from a mistake I made. I apologized and it changed my life.

November 6, 2019

Organizational Evidence-Based and Promising Practices for Improving Clinician Well-Being.

November 11, 2020

Hospital-error oversight called lax: state takes too long to investigate mistakes, patient advocates say.

May 18, 2005

Deficiencies in Care, Care Coordination, and Facility Response to a Patient Who Died by Suicide, Memphis VA Medical Center in Tennessee.

September 30, 2020

Deficiencies in the Veterans Crisis Line Response to a Veteran Caller Who Died.

December 16, 2020

Inadequate Emergency Department Care and Physician Misconduct at the Washington DC VA Medical Center.

August 12, 2020

Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.

July 15, 2020

Coronavirus: can this California prison save itself from Covid-19?

August 5, 2020

Medicare Part D Beneficiaries at Serious Risk of Opioid Misuse or Overdose: A Closer Look.

May 20, 2020

Drive to Deprescribe.

June 23, 2021

Healthcare Simulation Dictionary, Second Edition.

November 23, 2016

A girl dies during restraint at hospital already criticized for problems.

August 11, 2010

Implementation and facilitation of post-resuscitation debriefing: a comparative crossover study of two post-resuscitation debriefing frameworks.

November 2, 2022

2013 John M. Eisenberg Patient Safety and Quality Award Recipients Announced.

January 29, 2014

2010 John M. Eisenberg Patient Safety and Quality Award Recipients.

January 19, 2011

What a new doctor learned about medical mistakes from her Mom's death.

January 23, 2013

Home medical device safety tops ECRI'S list of healthcare technology.

February 15, 2023

Cause of death: sloppy doctors.

January 31, 2007

Prescribing errors in post-COVID-19 patients: prevalence, severity, and risk factors in patients visiting a post-COVID-19 outpatient clinic.

March 23, 2022

Doctors make mistakes. A new documentary explores what happens when they do—and how to fix it.

February 6, 2019

Supporting second victims.

February 21, 2018

10 medical errors that changed the standard of care.

February 15, 2012

Involving Patients in Improving Safety.

January 30, 2013

Soaring numbers of 111 callers forced to wait for a call back.

February 10, 2016

Patient Safety Initiative: Hospital Executive and Physician Leadership Strategies.

January 28, 2015

Medical disrespect.

February 12, 2014

Mental health conditions leading cause of pregnancy-related deaths.

February 15, 2023

Addressing intimate partner violence and helping to protect patients.

February 2, 2022

Related Resources

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Minimize medication errors in urgent care clinics.

March 15, 2023

CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.

November 16, 2022

Association of diagnostic stewardship for blood cultures in critically ill children with culture rates, antibiotic use, and patient outcomes: results of the Bright STAR Collaborative.

May 18, 2022

Clinician distress and inappropriate antibiotic prescribing for acute respiratory tract infections: a retrospective cohort study.

May 11, 2022

Comparison of a focused family cancer history questionnaire to family history documentation in the electronic medical record.

March 16, 2022

Aligning patient safety and stewardship: a harm reduction strategy for children.

December 22, 2021

Therapeutic duplication on the general surgical wards.

October 13, 2021

‘He thought what he was doing was good for people.’ Why is it so difficult to prevent unnecessary medical procedures in the U.S. health-care system?

September 1, 2021

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care.

August 11, 2021

Assessment of patient-preferred language to achieve goal-aligned deprescribing in older adults.

June 30, 2021

Evaluation of older persons' medications: a critical incident technique study exploring healthcare professionals' experiences and actions.

June 23, 2021

Accuracy of practitioner estimates of probability of diagnosis before and after testing.

May 5, 2021

Patient and physician perspectives of deprescribing potentially inappropriate medications in older adults with a history of falls: a qualitative study.

May 5, 2021

Keeping patients on track with preventative care during pandemic.

March 17, 2021

Optimizing Health IT for Safe Integration of Behavioral Health and Primary Care.

February 17, 2021

Prolonged diagnostic intervals as marker of missed diagnostic opportunities in bladder and kidney cancer patients with alarm features: a longitudinal linked data study.

February 17, 2021

Not ‘just depression.’ She seemed trapped in a downward mental health spiral. The real cause was a profound shock.

February 3, 2021

Missed acute coronary syndrome during telephone triage at out-of-hours primary care: lessons from a case-control study.

February 3, 2021

Doctors turned my sister away; less than two years later she died of cervical cancer.

September 9, 2020

Two pandemics, same story: the potentially dangerous overuse of antibiotics and 'the road to medical hell'.

September 9, 2020

The paradoxes of defensive medicine.

August 26, 2020

Annotated bibliography: an update to: "Understanding ambulatory care practices in the context of patient safety and quality improvement."

July 21, 2020

Second opinions improve healthcare outcomes and reduce costs.

June 24, 2020

The prevalence and impact of potentially inappropriate prescribing among older persons in primary care settings: multilevel meta-analysis.

May 27, 2020

Overcoming COVID-19: what can human factors and ergonomics offer?

May 6, 2020

Seattle pilot’s misdiagnosis highlights challenges around coronavirus testing.

April 15, 2020

Eliminating Medication Overload: A National Action Plan.

April 1, 2020

Prescription drug overload: critics fighting to curb an epidemic of medication side effects.

January 29, 2020

Assessment of unintentional duplicate orders by emergency department clinicians before and after implementation of a visual aid in the electronic health record ordering system.

January 22, 2020

See More About The Topic

How one medical checkup can snowball into a ‘cascade’ of tests, causing more harm than good.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

How one medical checkup can snowball into a ‘cascade’ of tests, causing more harm than good.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

PSNet Log in

Submit Your Case

Continue as a Guest

Continue Logged In

Submit Your Case

Continue as a Guest

Already have a PSNet

Account?

New Users

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site