Evidence map›Paper›PMID 35705901›Full record

Observational studyBMC emergency medicine2022

Frequency and predictors of unspecific medical diagnoses in the emergency department: a prospective observational study.

Tanja Birrenbach, Michele Hoffmann, Stefanie C Hautz, Juliane E Kämmer, Aristomenis K Exadaktylos, Thomas C Sauter, Martin Müller, Wolf E Hautz

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Tanja BirrenbachDepartment of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3010, Bern, Switzerland. Tanja.Birrenbach@insel.ch.
Michele HoffmannDepartment of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3010, Bern, Switzerland.
Stefanie C HautzDepartment of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3010, Bern, Switzerland.
Juliane E KämmerDepartment of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3010, Bern, Switzerland.
Aristomenis K ExadaktylosDepartment of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3010, Bern, Switzerland.
Thomas C SauterDepartment of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3010, Bern, Switzerland.
Martin Müller *Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3010, Bern, Switzerland.
Wolf E Hautz *Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3010, Bern, Switzerland.
University Hospital of Bern · CHUniversity of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMisdiagnosis is a major public health problem, causing increased morbidity and mortality. In the busy setting of an emergency department (ED) patients are diagnosed under difficult circumstances. As a consequence, the ED diagnosis at hospital admittance may often be a descriptive diagnosis, such as "decreased general condition". Our objective was to determine in how far patients with such an unspecific ED diagnosis differ from patients with a specific ED diagnosis and whether they experience a worse outcome.

methodsWe conducted a prospective observational study in Bern university hospital in Switzerland for all adult non-trauma patients admitted to any internal medicine ward from August 15th 2015 to December 7th 2015. Unspecific ED diagnoses were defined through the clinical classification software for ICD-10 by two outcome assessors. As outcome parameters, we assessed in-hospital mortality and length of hospital stay.

resultsSix hundred eighty six consecutive patients were included. Unspecific diagnoses were identified in 100 (14.6%) of all consultations. Patients receiving an unspecific diagnosis at ED discharge were significantly more often women (56.0% vs. 43.9%, p = 0.024), presented more often with a non-specific complaint (34% vs. 21%, p = 0.004), were less often demonstrating an abnormal heart rate (5.0% vs. 12.5%, p = 0.03), and less often on antibiotics (32.0% vs. 49.0%, p = 0.002). Apart from these, no studied drug intake, laboratory or clinical data including change in diagnosis was associated significantly with an unspecific diagnosis. Unspecific diagnoses were neither associated with in-hospital mortality in multivariable analysis (OR = 1.74, 95% CI: 0.60-5.04; p = 0.305) adjusted for relevant confounders nor with length of hospital stay (GMR = 0.87, 95% CI: 0.23-3.32; p = 0.840).

conclusionsWomen and patients with non-specific presenting complaints and no abnormal heart rate are at risk of receiving unspecific ED diagnoses that do not allow for targeted treatment, discharge and prognosis. This study did not find an effect of such diagnoses on length of hospital stay nor in-hospital mortality.

Indexed as

Emergency Service, HospitalPatient DischargeAdultFemaleHospital MortalityHumansLength of StayProspective StudiesDiagnostic errorEmergency departmentNon-specific complaintsUnspecific diagnoses

Identifiers

PMID35705901
PMCPMC9199121
OpenAlexW4282940426

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.