ArticleCritical care medicine2023
Prevalence and Characteristics of Diagnostic Error in Pediatric Critical Care: A Multicenter Study.
Article in Critical care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors influencing patient safety incident reporting in African healthcare organisations: a systematic integrative review.BMC health services research · 2025Pooled it
- Managing and Communicating Diagnostic Uncertainty in Pediatric Emergency Care: National Insights and Opportunities for Intervention.Pediatric emergency care · 2026Article
- Physician-Reported Diagnostic Uncertainty Among Children Discharged From the Pediatric Emergency Department With Acute Respiratory Illness.Pediatric emergency care · 2026Article
- Priorities for improving paediatric diagnosis: findings from a modified Delphi study.BMJ quality & safety · 2026Article
- Assessment of Generative AI Chatbots for Neonatal Diagnostic Reasoning: A Comparative Concordance and Diagnosis Acceptability Analysis.Indian journal of pediatrics · 2026Article
- Epidemiology of diagnostic errors in pediatric emergency departments using electronic triggers.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Evaluation of Measure Dx, a Resource to Accelerate Diagnostic Safety Learning and Improvement.Journal of general internal medicine · 2025Observational
- Diagnostic Uncertainty Among Critically Ill Children Admitted to the PICU: A Multicenter Study.Critical care medicine · 2025Article
- Patient-Clinician Diagnostic Concordance upon Hospital Admission.Applied clinical informatics · 2024Article
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26 authors.
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Abstract
objectivesEffective interventions to prevent diagnostic error among critically ill children should be informed by diagnostic error prevalence and etiologies. We aimed to determine the prevalence and characteristics of diagnostic errors and identify factors associated with error in patients admitted to the PICU.
designMulticenter retrospective cohort study using structured medical record review by trained clinicians using the Revised Safer Dx instrument to identify diagnostic error (defined as missed opportunities in diagnosis). Cases with potential errors were further reviewed by four pediatric intensivists who made final consensus determinations of diagnostic error occurrence. Demographic, clinical, clinician, and encounter data were also collected.
settingFour academic tertiary-referral PICUs. PATIENTS: Eight hundred eighty-two randomly selected patients 0-18 years old who were nonelectively admitted to participating PICUs.
interventionsNone. MEASUREMENTS AND MAIN
resultsOf 882 patient admissions, 13 (1.5%) had a diagnostic error up to 7 days after PICU admission. Infections (46%) and respiratory conditions (23%) were the most common missed diagnoses. One diagnostic error caused harm with a prolonged hospital stay. Common missed diagnostic opportunities included failure to consider the diagnosis despite a suggestive history (69%) and failure to broaden diagnostic testing (69%). Unadjusted analysis identified more diagnostic errors in patients with atypical presentations (23.1% vs 3.6%, p = 0.011), neurologic chief complaints (46.2% vs 18.8%, p = 0.024), admitting intensivists greater than or equal to 45 years old (92.3% vs 65.1%, p = 0.042), admitting intensivists with more service weeks/year (mean 12.8 vs 10.9 wk, p = 0.031), and diagnostic uncertainty on admission (77% vs 25.1%, p < 0.001). Generalized linear mixed models determined that atypical presentation (odds ratio [OR] 4.58; 95% CI, 0.94-17.1) and diagnostic uncertainty on admission (OR 9.67; 95% CI, 2.86-44.0) were significantly associated with diagnostic error.
conclusionsAmong critically ill children, 1.5% had a diagnostic error up to 7 days after PICU admission. Diagnostic errors were associated with atypical presentations and diagnostic uncertainty on admission, suggesting possible targets for intervention.
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