Trial reportJAMA internal medicine2018
Effect of Systematic Physician Cross-checking on Reducing Adverse Events in the Emergency Department: The CHARMED Cluster Randomized Trial.
Trial report in JAMA internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02356926 (Cross Checking to Reduce Adverse Events Resulting From Medical Errors in the Emergency Department), which is not on this map. Cited by 22 papers.
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.
Cross Checking to Reduce Adverse Events Resulting From Medical Errors in the Emergency Department
Who cites it
22 citing papers in PubMed.
- Trial
- Trial
- Informal peer diagnostic second opinion: Hospitalist practices and perspectives.Journal of hospital medicine · 2026Article
- Enhancing Patient Safety in Critical Care Settings: Lessons from a Multidimensional Special Issue.Healthcare (Basel, Switzerland) · 2026Article
- Development and prospective shadow evaluation of a domain-specific large language model for emergency neurological diagnosis.NPJ digital medicine · 2026Article
- Using Video Ethnography and Stimulated Recall Interviews to Describe the Diagnostic Process in the Emergency Department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Initial Clinical Impressions Are Absent in Around a Quarter of Adult Emergency Department Patient Consultations: Let's Get Back to Basics.Emergency medicine Australasia : EMA · 2025Article
- Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned.Diagnosis (Berlin, Germany) · 2025Article
- A high-quality dataset featuring classified and annotated cervical spine X-ray atlas.Scientific data · 2024Article
- No waiting lying in a corridor: a quality improvement initiative in an emergency department.BMJ open quality · 2023Article
- Can an End-to-End Telesepsis Solution Improve the Severe Sepsis and Septic Shock Management Bundle-1 Metrics for Sepsis Patients Admitted From the Emergency Department to the Hospital?Critical care explorations · 2022Article
- Article
- The impact of COVID-19 on Emergency Department length of stay for urgent and life-threatening patients.BMC health services research · 2022Article
- A Didactic Escape Game for Emergency Medicine Aimed at Learning to Work as a Team and Making Diagnoses: Methodology for Game Development.JMIR serious games · 2021Article
- Peer Discussion Decreases Practice Intensity and Increases Certainty in Clinical Decision-Making Among Internal Medicine Residents.Journal of graduate medical education · 2021Article
- Adverse events in the paediatric emergency department: a prospective cohort study.BMJ quality & safety · 2021Article
- Diagnostic Errors Induced by a Wrong a Priori Diagnosis: A Prospective Randomized Simulator-Based Trial.Journal of clinical medicine · 2021Article
- Emergency Department and Overcrowding During COVID-19 Outbreak; a Letter to Editor.Archives of academic emergency medicine · 2021Article
- Review of the Basics of Cognitive Error in Emergency Medicine: Still No Easy Answers.The western journal of emergency medicine · 2020Review
- Article
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Emergency departments (ED) are environments that are at high risk for medical errors. Previous studies suggested that the proportion of medical errors may decrease when more than 1 physician is involved. Objective: To reduce the proportion of medical errors by implementing systematic cross-checking between emergency physicians. Design, Setting, and Participants: This cluster randomized crossover trial includes a random sample of 14 adult patients (age ≥18 years) per day during two 10-day period in 6 EDs (n = 1680 patients) in France. Interventions: Systematic cross-checking between emergency physicians, 3 times a day, which included a brief presentation of one physician's case to another, followed by the second physician's feedback to the first. Main Outcomes and Measures: Medical error in the ED, defined as an adverse event (either a near miss or a serious adverse event). The primary end point was identified using a 2-level error detection surveillance system, blinded to the strategy allocation. Results: Among the 1680 included patients (mean [SD] age, 57.5 [21.7] years), 144 (8.6%) had an adverse event. There were 54 adverse events among 840 patients (6.4%) in the cross-check group compared with 90 adverse events among 840 patients (10.7%) in the standard care group (relative risk reduction [RRR], 40% [95% CI, 12% to 59%]; absolute risk reduction [ARR], 4.3%; number needed to treat [NNT], 24). There was also a significant reduction rate of near misses (RRR, 47% [95% CI, 15% to 67%]; ARR, 2.7%; NNT, 37) but not of the rate of preventable serious adverse events (RRR, 29% [95% CI, -18% to 57%]; ARR, 1.2%; NNT, 83). Conclusions and Relevance: The implementation of systematic cross-checking between emergency physicians was associated with a significant reduction in adverse events, mainly driven by a reduction in near misses. Trial Registration: ClinicalTrials.gov Identifier: NCT02356926.
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