ArticleBMJ quality & safety2021
Use of patient complaints to identify diagnosis-related safety concerns: a mixed-method evaluation.
Article in BMJ quality & safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 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.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Developing a framework for understanding diagnostic reconciliation based on evidence review, stakeholder engagement, and practice evaluation.Diagnosis (Berlin, Germany) · 2025Pooled it
- Scoping review of patient and family engagement interventions in diagnosis: a paradox of too much, yet so little.BMJ quality & safety · 2026Article
- Understanding Medication Errors Through Patient Complaints in a Danish University Hospital.Basic & clinical pharmacology & toxicology · 2026Article
- Defining an integrative multidimensional framework for patient complaint management systems.Frontiers in health services · 2026Review
- Ten years on: how far have we come in patient engagement in diagnosis?Diagnosis (Berlin, Germany) · 2025Review
- Two decades of diagnostic safety research: advances, challenges, and next steps.Diagnosis (Berlin, Germany) · 2025Review
- From challenge to growth: Exploring physician narratives of patient complaints during residency.Medical education · 2025Review
- The hidden dangers in routine medical complaints: uncovering patient harm.BMC health services research · 2025Article
- The evolution of patient-reported safety concerns during the COVID-19 pandemic within a series of study questionnaires: a multi-method analysis.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025Article
- Evaluation of Measure Dx, a Resource to Accelerate Diagnostic Safety Learning and Improvement.Journal of general internal medicine · 2025Observational
- Charting Diagnostic Safety: Exploring Patient-Provider Discordance in Medical Record Documentation.Journal of general internal medicine · 2025Article
- Spatial-temporal analysis of patient complaints in Shanghai from 2015 to 2022.BMC health services research · 2025Article
- Benefits and challenges of implementing statutory duty of candour in Victoria, Australia: a mixed methods analysis of healthcare provider perspectives.Frontiers in health services · 2025Article
- Patient safety reporting and learning system of Catalonia (SNiSP Cat): a health policy initiative to enhance culture, leadership and professional engagement.BMJ open quality · 2024Article
- Adverse Event Signal Detection Using Patients' Concerns in Pharmaceutical Care Records: Evaluation of Deep Learning Models.Journal of medical Internet research · 2024Article
- Co-Design with Patients for Improving Patient Safety: Strategies, Barriers and pitfalls.Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting. Human Factors and Ergonomics Society. Annual meeting · 2023Article
- Collecting Patient Feedback as a Means of Monitoring Patient Experience and Hospital Service Quality - Learning from a Government-led Initiative.Patient preference and adherence · 2023Article
- Patient Identification of Diagnostic Safety Blindspots and Participation in "Good Catches" Through Shared Visit Notes.The Milbank quarterly · 2022Article
- Creating a Learning Health System for Improving Diagnostic Safety: Pragmatic Insights from US Health Care Organizations.Journal of general internal medicine · 2022Article
- Inviting patients to identify diagnostic concerns through structured evaluation of their online visit notes.Journal of the American Medical Informatics Association : JAMIA · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPatient complaints are associated with adverse events and malpractice claims but underused in patient safety improvement.
objectiveTo systematically evaluate the use of patient complaint data to identify safety concerns related to diagnosis as an initial step to using this information to facilitate learning and improvement.
methodsWe reviewed patient complaints submitted to Geisinger, a large healthcare organisation in the USA, from August to December 2017 (cohort 1) and January to June 2018 (cohort 2). We selected complaints more likely to be associated with diagnostic concerns in Geisinger's existing complaint taxonomy. Investigators reviewed all complaint summaries and identified cases as 'concerning' for diagnostic error using the National Academy of Medicine's definition of diagnostic error. For all 'concerning' cases, a clinician-reviewer evaluated the associated investigation report and the patient's medical record to identify any missed opportunities in making a correct or timely diagnosis. In cohort 2, we selected a 10% sample of 'concerning' cases to test this smaller pragmatic sample as a proof of concept for future organisational monitoring.
resultsIn cohort 1, we reviewed 1865 complaint summaries and identified 177 (9.5%) concerning reports. Review and analysis identified 39 diagnostic errors. Most were categorised as 'Clinical Care issues' (27, 69.2%), defined as concerns/questions related to the care that is provided by clinicians in any setting. In cohort 2, we reviewed 2423 patient complaint summaries and identified 310 (12.8%) concerning reports. The 10% sample (n=31 cases) contained five diagnostic errors. Qualitative analysis of cohort 1 cases identified concerns about return visits for persistent and/or worsening symptoms, interpersonal issues and diagnostic testing.
conclusionsAnalysis of patient complaint data and corresponding medical record review identifies patterns of failures in the diagnostic process reported by patients and families. Health systems could systematically analyse available data on patient complaints to monitor diagnostic safety concerns and identify opportunities for learning and improvement.
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What OpenQuestion holds
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.