Missed diagnosis of stroke in emergency medicine settings is an important patient safety problem. In this study, researchers interviewed emergency medicine physicians about their perspectives on diagnostic neurology and use of clinical decision support (CDS) tools. Themes emerged related to challenges in diagnosis, neurological complaints, and challenges in diagnostic decision-making in emergency medicine, more generally. Participating physicians were enthusiastic about the possibility of involving CDS tools to improve diagnosis for non-specific neurological complaints.

Diagnostic errors are common and often related to cognitive processes, with many retrospectively discovered through review of closed malpractice claims or at time of autopsy. This study used a web-based clinical decision support system called Isabel to determine its ability to accurately diagnose acute medical problems compared with final discharge diagnoses and a panel of experts. Building on a past study, investigators discovered that the system displayed the final discharge diagnosis in 95% of inpatients. The authors highlight the potential benefits of integrating such a system into daily practice and call for further study on whether it reduces diagnostic error. An AHRQ WebM&M conversation with Dr. Britto, the co-founder of Isabel Healthcare Inc., discusses eradicating diagnostic errors through such decision support systems.