Search results for "United States of America"

Overdiagnosis has emerged as a quality and safety concern due to its potential to result in harm for patients and their families. This conference will explore methods to define overdiagnosis, why it occurs, and strategies to reduce its incidence.

Misdiagnosis is common and can lead to unnecessary care, overuse, and increased costs. According to this study, misdiagnosis of cellulitis may result in anywhere from 50,000 to 130,000 unnecessary hospitalizations annually, leading to hundreds of millions of dollars in needless health care spending.

Although genetic testing can provide proactive assessment for disease, it can also result in unnecessary care. This news article reports on the unexpected death of a child and how the family experienced psychological harm and received unnecessary care due to misdiagnosis related to false positive test results for long QT syndrome.

Delayed diagnoses can have serious consequences. This news article reviews several examples of misdiagnosis and insights from the patients and families involved, explores the importance of engaging patients in determining correct diagnoses, and places the discussion in the broader context of efforts to reduce diagnostic error.

Diagnostic error remains a significant source of preventable patient harm. Because bias on the part of health care providers can contribute to diagnostic errors, improving the medical decision-making process may serve as an error prevention strategy, possibly through the use of collective intelligence. This study sought to better understand the conditions under which collective intelligence might augment medical judgment. Using large data sets consisting of more than 140 doctors and 20,000 diagnoses, the investigators determined that when providers have similar individual diagnostic accuracy rates, pooling their judgments improves decision accuracy. However, if accuracy levels vary across providers, pooling independent judgment leads to worse diagnostic outcomes. The authors suggest that similar diagnostic accuracy should be a key condition when creating groups for the purpose of improving medical diagnosis. A previous WebM&M commentary discussed a case of diagnostic error.

Patients are increasingly using online symptom checkers for medical information and health care recommendations. This newspaper article reports on various health information applications that provide triage advice to patients and points out that physicians have significantly lower rates of diagnostic errors.

In light of the growing focus on diagnostic errors, this magazine series reports on unique challenges that pathologists face when they discover potential errors. The first article in the series discusses how pathologists may experience barriers to disclosure including feeling shame in disclosing their own error, discomfort with raising concerns about a colleague who has misdiagnosed a patient, and lack of direct relationships with patients. The second article expands the discussion to focus on how industry support of open transparency can enable pathologists to participate in reporting and disclosure activities.

This case study describes five cases of dizziness, each incorrectly diagnosed by a physician and subsequently correctly diagnosed by a physical therapist. The authors argue for involving allied health professionals in the diagnostic process, as recommended in the Improving Diagnosis report.

The frequency of diagnostic errors in outpatient care remains unclear. In this survey of outpatient general pediatricians, about one-third reported making a diagnostic error every month. This finding underscores the importance of enhancing the safety of diagnosis in ambulatory settings.

Early intervention for sepsis can improve patient outcomes, and in turn prompt diagnosis is critical. Using case vignettes, this survey of intensivists found substantial variation in accurately diagnosing sepsis. This work has significant implications for initiatives aimed at improving the timely recognition of this condition.

Rare diseases can present unique diagnostic challenges for clinicians. This commentary draws from a historical case of diagnostic error to illustrate how availability bias and lack of sensitivity for patients who are considered difficult can contribute to misdiagnosis.

Delayed diagnosis of infectious disease can negatively affect patients, care teams, and public health. Reviewing insights from a panel analysis of the well-known incident involving delayed diagnosis of Ebola virus, this report highlights the need to improve information transfer and emergency department safety culture to enhance diagnostic and infection prevention processes.

Diagnostic error is garnering increased attention as a patient safety problem. This news article reports on how misdiagnosis may lead to patient harm, cognitive biases that can contribute to diagnostic errors, and a curriculum aimed at improving diagnostic reasoning.

Diagnostic errors are moving toward the forefront of patient safety. This study analyzed Medicare patients that were initially misdiagnosed as having Alzheimer disease prior to their diagnosis of vascular dementia or Parkinson disease. These patients used more medical services, costing approximately $9,500 to $14,000 more each year, up until the time of their correct diagnosis.

This study assessed an error of omission—failure to assess children for occult fractures—in several clinically indicated situations, and found that such errors occur in about half of cases. Interventions to prompt specific actions, like checklists, may be useful in this clinical arena.

Diagnostic errors are a known cause of preventable adverse events. The vast majority of children ultimately determined to have fetal alcohol spectrum disorder in this cohort study had been previously misdiagnosed, despite having undergone clinical evaluation for developmental or behavioral problems.

This news article reports on the widely publicized delayed diagnosis of Ebola at a Dallas hospital and reveals previously undisclosed details from the emergency room physician who misdiagnosed the patient when he first presented, including information and communication gaps that may have contributed to the failure.

Although missed and delayed diagnoses are known to contribute to morbidity and mortality, measuring the extent of their impact on patient safety remains a challenge. In this study, researchers sought to identify missed diagnosis of acute myocardial infarction (AMI) using administrative data, an approach similar to prior studies of diagnostic accuracy. They suggest that patients treated in the emergency department for chest pain or a cardiac condition and released, who were then hospitalized for AMI within 7 days of that visit experienced a missed AMI diagnosis. The authors estimate that nearly 1% of AMI admissions represent a prior missed diagnosis. Younger patients and black patients had higher odds of missed diagnosis, raising concerns for disparities in the diagnostic process. Conversely, teaching hospital status and availability of cardiac catheterization were associated with lower odds of missed diagnosis, suggesting that settings where AMI is more commonly treated have higher diagnostic accuracy, mirroring earlier research on cognition and diagnosis. This study represents a promising approach for identifying missed diagnosis for other common conditions using available data.

According to this study, the relationship between resident physicians' diagnostic accuracy and degree of certainty is dependent on context. When trainees were given inconsistent clinical information, there was no correlation between how accurate their diagnosis was and how certain they felt. The authors conclude that diagnostic accuracy and certainty are poor proxies for each other.

This direct observation study examined cognition among experienced clinicians in the setting of their recertification examination and found that when they changed answers, it was usually from an incorrect to a correct response. This suggests that further reflection enhances accuracy compared to intuitive response, consistent with work on metacognition to enhance diagnostic accuracy.