Stop the silent misdiagnosis: patients' preferences matter.

Albert G Mulley; Chris Trimble; Glyn Elwyn

Commentary

Stop the silent misdiagnosis: patients' preferences matter.

November 21, 2012

Mulley AG, Trimble C, Elwyn G. BMJ. 2012;345:e6572.

View more articles from the same authors.

This commentary describes how misidentifying patients' preferences affects their care and recommends tactics to prevent it.

Related news article

PubMed citation

Available at

Related Resources From the Same Author(s)

Patient safety and patient error.

January 31, 2007

The patient safety story.

August 17, 2005

Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems.

February 2, 2020

Patient error: a preliminary taxonomy.

May 27, 2009

Approaches to reducing the most important patient errors in primary health-care: patient and professional perspectives.

February 24, 2010

The thinking doctor: clinical decision making in contemporary medicine.

August 31, 2016

Medication errors associated with transition from insulin pens to insulin vials.

March 8, 2017

'I think this medicine actually killed my wife': patient and family perspectives on shared decision-making to optimize medications and safety.

July 17, 2019

Patient safety in otolaryngology: a descriptive review.

November 16, 2016

Reporting of perioperative adverse events by pediatric anesthesiologists at a tertiary children's hospital: targeted interventions to increase the rate of reporting.

October 11, 2017

The perianesthesia nurse's role in the prevention of opioid-related sentinel events.

April 3, 2013

Supporting the emotional well-being of health care workers during the COVID-19 pandemic.

August 5, 2020

Systematic review of the application of the plan-do-study-act method to improve quality in healthcare.

October 16, 2013

The quality, safety and content of telephone and face-to-face consultations: a comparative study.

June 2, 2010

Effectiveness and efficiency of root cause analysis in medicine.

February 27, 2008

Integrating knowledge-based resources into the electronic health record: history, current status, and role of librarians.

August 29, 2007

Fatigue in radiology: a fertile area for future research.

July 31, 2019

Intensive care medicine in 2050: preventing harm.

May 1, 2019

Clinicians' expectations of the benefits and harms of treatments, screening, and tests: a systematic review.

February 1, 2017

Patients' expectations of the benefits and harms of treatments, screening, and tests: a systematic review.

January 21, 2015

Safer care at home: use of simulation training to improve standards.

October 19, 2011

The evolving curriculum in quality improvement and patient safety in undergraduate and graduate medical education: a scoping review.

February 15, 2023

A mediation skills model to manage disclosure of errors and adverse events to patients.

September 21, 2005

Preventing medication errors.

August 10, 2016

Critical incident stress debriefing after adverse patient safety events.

August 9, 2017

Medical error: the second victim.

November 21, 2012

Development of a modified early warning score using the electronic medical record.

August 31, 2011

Safety culture in Indian hospitals: a cultural adaptation of the Safety Attitudes Questionnaire.

May 21, 2014

The impact of the use of employee functional flexibility on patient safety.

November 18, 2020

'If no-one stops me, I'll make the mistake again': changing prescribing behaviours through feedback; a Perceptual Control Theory perspective.

May 10, 2017

Piece of my mind. Stories doctors tell.

July 19, 2017

A systems approach to evaluating ionizing radiation: six focus areas to improve quality, efficiency, and patient safety.

June 24, 2015

Adverse drug event–related emergency department visits associated with complex chronic conditions.

June 11, 2014

Impact of an electronic health record alert on inappropriate prescribing of high-risk medications to patients with concurrent "do not give" orders.

August 3, 2022

Does one size fit all? Assessing the need for organizational second victim support programs.

April 7, 2021

What can patient safety teach us about clinician burnout?

January 8, 2020

Understanding interrater reliability and validity of risk assessment tools used to predict adverse clinical events.

March 15, 2017

Close calls in patient safety: should we be paying closer attention?

May 15, 2013

Medical error, incident investigation and the second victim: doing better but feeling worse?

April 4, 2012

Injury and death associated with incidents reported to the Patient Safety Net.

September 23, 2009

Managing cognitive biases during disaster response: the development of an aide memoire.

May 20, 2020

Safe work-hour standards for parents of children with medical complexity.

January 29, 2020

Office surgery incidents: what seven years of Florida data show us.

March 26, 2008

Identification of warning signs during selection of surgical trainees.

January 16, 2019

Evaluation for occult fractures in injured children.

August 5, 2015

Harm caused by adverse events in primary care: a clinical observational study.

April 15, 2009

Mix of methods is needed to identify adverse events in general practice: a prospective observational study.

July 23, 2008

Time for transparent standards in quality reporting by health care organizations.

August 16, 2017

Emotional influences in patient safety.

October 20, 2010

Clinician mindfulness and patient safety.

December 15, 2010

Quality-monitoring program for bar-code–assisted medication administration.

June 17, 2009

COVID-19: peer support and crisis communication strategies to promote institutional resilience.

April 22, 2020

Putting the patient in patient safety investigations: barriers and strategies for involvement.

June 3, 2020

Do hospitals support second victims? Collective insights from patient safety leaders in Maryland.

July 19, 2017

On higher ground: ethical reasoning and its relationship with error disclosure.

April 24, 2013

A framework for encouraging patient engagement in medical decision making.

August 29, 2012

How to discuss errors and adverse events with cancer patients.

June 16, 2010

Safety as a criterion for quality: The Critical Nursing Situation Index in paediatric critical care, an observational study.

November 4, 2009

Ethical and practical aspects of disclosing adverse events in the emergency department.

October 4, 2006

Evolving quality improvement support strategies to improve Plan–Do–Study–Act cycle fidelity: a retrospective mixed-methods study.

May 1, 2019

Using simulation to identify sources of medical diagnostic error in child physical abuse.

April 27, 2016

Closing the safety loop: evaluation of the National Patient Safety Agency's guidance regarding wristband identification of hospital inpatients.

April 29, 2009

Empowering patient safety outreach through interprofessional partnerships: educating our communities.

August 25, 2010

RISE: exploring volunteer retention and sustainability of a second victim support program.

February 3, 2021

The effect of an electronic SBAR communication tool on documentation of acute events in the pediatric intensive care unit.

October 22, 2014

Beyond the clinical team: evaluating the human factors-oriented training of non-clinical professionals working in healthcare contexts.

July 17, 2019

Prevalence of polypharmacy exposure among hospitalized children in the United States.

September 28, 2011

Exploring the role of communications in quality improvement: a case study of the 1000 Lives Campaign in NHS Wales.

May 27, 2015

Application of a theoretical framework for behavior change to hospital workers' real-time explanations for noncompliance with hand hygiene guidelines.

January 22, 2014

'I guess I'll wait to hear'- communication of blood test results in primary care a qualitative study.

August 3, 2022

Exploring the relationship between contact frequency, leader-member relationships, and patient safety culture

October 2, 2019

Disclosing medical errors to patients: it's not what you say, it's what they hear.

July 22, 2009

Review of alternatives to root cause analysis: developing a robust system for incident report analysis.

September 18, 2019

How do stakeholders experience the adoption of electronic prescribing systems in hospitals? A systematic review and thematic synthesis of qualitative studies.

September 18, 2019

When no news is bad news: improving diagnostic testing communication through patient engagement.

March 9, 2022

Hospital at Home: setting a regulatory course to ensure safe, high-quality care.

February 2, 2022

Disclosure of patient safety incidents: a comprehensive review.

September 1, 2010

Patient-assisted incident reporting: including the patient in patient safety.

June 1, 2011

Costs and benefits of an early-alert surveillance system for hospital inpatients.

February 28, 2007

Identifying hot spots for harm and blind spots across the care pathway from patient complaints about general practice.

November 3, 2021

Association between electronic health record implementations and hospital-acquired conditions in pediatric hospitals.

August 2, 2023

Challenges and opportunities from the Agency for Healthcare Research and Quality (AHRQ) research summit on improving diagnosis: a proceedings review.

June 14, 2017

Conflict of interest, Dr Charles Denham and the Journal of Patient Safety.

December 3, 2014

Workplace bullying in the OR: results of a descriptive study.

November 13, 2013

"That was a close call": endorsing a broad definition of near misses in health care.

October 2, 2013

How to develop a second victim support program: a toolkit for health care organizations.

May 2, 2012

Patient safety reporting: a qualitative study of thoughts and perceptions of experts 15 years after 'To Err is Human.'

August 12, 2015

Unplanned transfers to a medical intensive care unit: causes and relationship to preventable errors in care.

January 12, 2011

Health care workers as second victims of medical errors.

May 11, 2011

Medication reconciliation for reducing drug-discrepancy adverse events.

November 8, 2006

Disclosing errors and adverse events in the intensive care unit.

April 5, 2006

Double reading in breast cancer screening: cohort evaluation in the CO-OPS trial.

August 29, 2018

Efficacy, tolerability, and dose-dependent effects of opioid analgesics for low back pain: a systematic review and meta-analysis.

January 11, 2017

Implementation of the trigger review method in Scottish general practices: patient safety outcomes and potential for quality improvement.

April 12, 2017

Michigan Health & Hospital Association Keystone Obstetrics: a statewide collaborative for perinatal patient safety in Michigan.

January 30, 2005

Patient–doctor continuity and diagnosis of cancer: electronic medical records study in general practice.

May 13, 2015

Managing interruptions to improve diagnostic decision-making: strategies and recommended research agenda.

March 29, 2023

Prospective observational study on the incidence of medication errors during simulated resuscitation in a paediatric emergency department.

March 6, 2005

Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis.

March 28, 2007

Residents feel unprepared and unsupervised as leaders of cardiac arrest teams in teaching hospitals: a survey of internal medicine residents.

July 11, 2007

Related Resources

Widespread misinterpretation of advance directives and Portable Orders for Life-Sustaining Treatments threatens patient safety and causes undertreatment and overtreatment.

July 12, 2023

Disclosing medical errors: prioritising the needs of patients and families.

July 5, 2023

Patient Safety Innovations

Preventing Falls Through Patient and Family Engagement to Create Customized Prevention Plans

May 31, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Imagining the future of diagnostic performance feedback.

April 12, 2023

Racism and electronic health records (EHRs): perspectives for research and practice.

April 12, 2023

Recognizing our biases, understanding the evidence, and responding equitably: application of the socioecological model to reduce racial disparities in the NICU.

March 8, 2023

How should clinicians minimize bias when responding to suspicions about child abuse?

February 22, 2023

Advancing diagnostic equity through clinician engagement, community partnerships, and connected care.

February 22, 2023

People of color with long COVID face uphill battle to be heard.

October 12, 2022

Embedded bias: how medical records sow discrimination.

October 5, 2022

Sixty seconds on . . . medical gaslighting.

September 14, 2022

How cisgender clinicians can help prevent harm during encounters with transgender patients.

August 24, 2022

Without question.

July 20, 2022

Presenting complaint: use of language that disempowers patients.

May 11, 2022

Error and cognitive bias in diagnostic radiology.

April 13, 2022

The problem with…using stories as a source of evidence and learning.

March 9, 2022

A family and hospital's journey and commitment to improving diagnostic safety.

March 9, 2022

Addressing intimate partner violence and helping to protect patients.

February 2, 2022

Health disparities: impact of health disparities and treatment decision-making biases on cancer adverse effects among black cancer survivors.

November 10, 2021

'More than words' - interpersonal communication, cognitive bias and diagnostic errors.

August 11, 2021

Poor physician-patient communication and medical error.

June 30, 2021

Healthcare professionals' encounters with ethnic minority patients: the critical incident approach.

June 16, 2021

Testimonial injustice: linguistic bias in the medical records of black patients and women.

June 6, 2021

What COVID-19 teaches us about implicit bias in pediatric health care.

February 24, 2021

Speaking up about patient-perceived serious visit note errors: patient and family experiences and recommendations.

January 13, 2021

How structural racism works - racist policies as a root cause of U.S. racial health inequities.

December 17, 2020

A bottom-up approach addressing patient care and differential diagnosis amidst the Covid-19 response.

October 14, 2020

The practice of medicine: understanding diagnostic error.

September 23, 2020

Tolerance of uncertainty and the practice of emergency medicine.

July 15, 2020

See More About The Topic

Health Care Providers

Medicine

Psychological and Social Complications

Cognitive Errors ("Mistakes")

Provider-Patient Communication

Stop the silent misdiagnosis: patients' preferences matter.

Preventing Falls Through Patient and Family Engagement to Create Customized Prevention Plans

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Stop the silent misdiagnosis: patients' preferences matter.

Preventing Falls Through Patient and Family Engagement to Create Customized Prevention Plans

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

PSNet Log in

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