ArticleDiagnosis (Berlin, Germany)2021
Analyzing diagnostic errors in the acute setting: a process-driven approach.
Article in Diagnosis (Berlin, Germany), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Incidence, contributing factors, and predictors of diagnostic errors in medical inpatients: A retrospective cohort study.Journal of hospital medicine · 2026Article
- Exploring the dark side of the moon: diagnostic errors in critically ill patients.Intensive care medicine · 2025Article
- A Diagnostic Challenge for Bilateral Lung Involvement in a 13-Month-Old Saudi Child Due to Multiple Popcorn Kernel Aspirations: A Case Report.Clinical case reports · 2025Article
- Patient-Clinician Diagnostic Concordance upon Hospital Admission.Applied clinical informatics · 2024Article
- Diagnostic Errors in Hospitalized Adults Who Died or Were Transferred to Intensive Care.JAMA internal medicine · 2024Article
- Article
- Drug interference with biochemical laboratory tests.Biochemia medica · 2023Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectivesWe describe an approach for analyzing failures in diagnostic processes in a small, enriched cohort of general medicine patients who expired during hospitalization and experienced medical error. Our objective was to delineate a systematic strategy for identifying frequent and significant failures in the diagnostic process to inform strategies for preventing adverse events due to diagnostic error.
methodsTwo clinicians independently reviewed detailed records of purposively sampled cases identified from established institutional case review forums and assessed the likelihood of diagnostic error using the Safer Dx instrument. Each reviewer used the modified Diagnostic Error Evaluation and Research (DEER) taxonomy, revised for acute care (41 possible failure points across six process dimensions), to characterize the frequency of failure points (FPs) and significant FPs in the diagnostic process.
resultsOf 166 cases with medical error, 16 were sampled: 13 (81.3%) had one or more diagnostic error(s), and a total of 113 FPs and 30 significant FPs were identified. A majority of significant FPs (63.3%) occurred in "Diagnostic Information and Patient Follow-up" and "Patient and Provider Encounter and Initial Assessment" process dimensions. Fourteen (87.5%) cases had a significant FP in at least one of these dimensions.
conclusionsFailures in the diagnostic process occurred across multiple dimensions in our purposively sampled cohort. A systematic analytic approach incorporating the modified DEER taxonomy, revised for acute care, offered critical insights into key failures in the diagnostic process that could serve as potential targets for preventative interventions.
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