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Previous studies have used virtual patient cases to help trainees and practicing physicians improve diagnostic accuracy. Using virtual patients, this study found that brief lectures combined with 9 hours of supervised deliberate practice improved the ability of medical interns to correctly diagnose dizziness.

Diagnostic errors among patients presenting to the emergency department (ED) with abdominal pain are common. This article summarizes the factors associated with missed diagnoses of abdominal pain in the ED, the types of abdominal pain that are commonly misdiagnosed, and recommended steps for discharging a patient with abdominal pain without a final diagnosis.

Diagnostic safety is a patient safety priority across all medical specialties. Over a five-year period, researchers found that 15% of patients referred for psychosomatic consultations at one university hospital were misdiagnosed. Misdiagnosis was primarily attributed to availability bias or other biases. Semi-structured interviews with referring physicians highlight the contributing role of physician attitudes and unusual clinical features.

Misdiagnosis of cardiovascular conditions can lead to serious patient harm. This systematic review found that misdiagnosis of acute myocardial infarction (AMI) occurs in approximately 1-2% of cases, and AMI is commonly diagnosed as other heart conditions, musculoskeletal pain, or gastrointestinal disease. The authors suggest that there are opportunities to reduce cases of missed AMI with better education about atypical symptoms and improved training of electrocardiogram interpretation.

Autopsies are an important tool for identifying diagnostic errors. This retrospective study of 821 pediatric cancer deaths found that 10% had a major diagnostic discrepancy between antemortem and postmortem diagnoses. These discrepancies primarily consisted of missed infections, missed cancer diagnoses, and organ complications.

Sound critical thinking skills can help clinicians avoid cognitive biases and diagnostic errors. This article describes three critical thinking skills essential to effective clinical care – clinical reasoning, evidence-informed decision-making, and systems thinking – and approaches to develop these skills during clinician training.

Misdiagnosis of cardiovascular conditions can lead to serious patient harm. This systematic review explored misdiagnosis of heart failure. Based on 10 included studies, the rate of heart failure misdiagnosis ranged from 16.1% (in an inpatient setting) to 68.5% (when general practitioners referred patients to specialists). Included studies found that heart failure is frequently misdiagnosed as chronic obstructive pulmonary disease (COPD).

Diagnostic errors can result in increased length of stay and unplanned hospital readmissions. To reduce readmissions, this hospital implemented a diagnostic time-out to increase the frequency of documented differential diagnosis in pediatric patients admitted with abdominal pain. Results showed marginal improvement in quality of differential diagnosis.

Accurate and timely feedback about patient outcomes can inform and improve future clinical decision-making; however, many barriers exist that prevent effective feedback. This article suggests a sociotechnical approach using information technology (IT) to provide clinician feedback. Feedback sent using the electronic health record can be provided asynchronously, by any member of the care team, and in a structured format to ensure relevance and usefulness.

Lack of timely follow-up of test results is an ongoing patient safety problem in primary care and can lead to missed or delayed diagnoses. This systematic review concluded that follow-up of abnormal mammograms in primary care is suboptimal. Findings from included studies indicate that ethnic minorities and women with lower educational attainment were more likely to have inadequate follow-up. Factors influencing follow-up include physician-patient miscommunication, alert fatigue, difficulty obtaining test results or patient records, and logistical barriers. The authors suggest adopting interventions focused on mitigating factors that negatively impact follow-up, such as patient navigation and case management.