ArticleJournal of general internal medicine2005
Sins of omission: getting too little medical care may be the greatest threat to patient safety.
Article in Journal of general internal medicine, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01787175 (Veterans Affairs Integrated Medication Manager), which is not on this map. Cited by 36 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Veterans Affairs Integrated Medication Manager
Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- What do family physicians consider an error? A comparison of definitions and physician perception.BMC family practice · 2006Pooled it
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- Cognitive and Initial Psychometric Testing of the Errors of Care Omission Survey: A New Patient Safety Tool for Primary Care.Journal of nursing measurement · 2019Article
- Second victims in health care: current perspectives.Advances in medical education and practice · 2019Article
- Are we guilty of errors of omission on the potential role of electronic nicotine delivery systems as less harmful substitutes for combusted tobacco use?Preventive medicine · 2018Article
- It's not just what you know: junior trainees' approach to follow-up and documentation.Medical education · 2017Article
- What physicians reason about during admission case review.Advances in health sciences education : theory and practice · 2017Article
- Direct and indirect risk associated with the use of dietary supplements among persons with dementia in a Norwegian memory clinic.BMC complementary and alternative medicine · 2017Article
- Car Seat Safety: Typologies of Protective Health and Safety Behaviors for Mothers in West Virginia.Maternal and child health journal · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundLittle is known about the relative incidence of serious errors of omission versus errors of commission.
objectiveTo identify the most common substantive medical errors identified by medical record review.
designRetrospective cohort study.
settingTwelve Veterans Affairs health care systems in 2 regions.
participantsStratified random sample of 621 patients receiving care over a 2-year period.
main outcome measureClassification of reported quality problems.
methodsTrained physicians reviewed the full inpatient and outpatient record and described quality problems, which were then classified as errors of omission versus commission.
resultsEighty-two percent of patients had at least 1 error reported over a 13-month period. The average number of errors reported per case was 4.7 (95% confidence intervals [CI]: 4.4, 5.0). Overall, 95.7% (95% CI: 94.9%, 96.4%) of errors were identified as being problems with underuse. Inadequate care for people with chronic illnesses was particularly common. Among errors of omission, obtaining insufficient information from histories and physicals (25.3%), inadequacies in diagnostic testing (33.9%), and patients not receiving needed medications (20.7%) were all common. Out of the 2,917 errors identified, only 27 were rated as being highly serious, and 26 (96%) of these were errors of omission.
conclusionsWhile preventing iatrogenic injury resulting from medical errors is a critically important part of quality improvement, we found that the overwhelming majority of substantive medical errors identifiable from the medical record were related to people getting too little medical care, especially for those with chronic medical conditions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.