ArticleDiagnosis (Berlin, Germany)2025
Diagnostic errors in patients admitted directly from new outpatient visits.
Article in Diagnosis (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Atypical Presentations at Risk for Diagnostic Errors in Internal Medicine: A Scoping Review.Journal of general internal medicine · 2026Article
- A cross sectional study of the relationship between clinical scores and timing of guidance for resident physicians in outpatient settings.Scientific reports · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDiagnostic errors frequently represent significant adverse events that can occur in any medical setting, particularly in rushed handovers and constrained timing. Cases that result in emergency hospitalization at the time of the initial outpatient visit are more likely to have complex or serious patient conditions and more detrimental diagnostic errors. Our study investigated diagnostic errors in these under reported situations.
methodsWe conducted a retrospective study using electronic medical record data on patients who were directly admitted to a newly established outpatient clinic at a single university hospital in Japan. Diagnostic errors were assessed independently by two physicians using the Revised Safer Dx instrument. We analyzed patient demographics, symptoms, referrals, and resident doctor (postgraduate-year-1) involvement using logistic regression to compare groups with and without diagnostic error. Additionally, we employed the Diagnostic Error Evaluation and Research (DEER) taxonomy and Generic Diagnostic Pitfalls (GDP) to examine the factors associated with diagnostic errors.
resultsThe study included 321 patients, with diagnostic errors identified in 39 cases (12.1 %). Factors contributing to diagnostic errors included the involvement of young residents, male patients, the number of symptoms, and atypical presentation. The most common causes of diagnostic errors were "too much weight given to competing/coexisting diagnosis" as indicated by DEER and "atypical presentation" by GDP.
conclusionsThe frequency of diagnostic errors in this study was higher than those in previous studies of new outpatient visits, underscoring the imperative for heightened scrutiny in cases involving medical residents especially when patients present with multiple or atypical symptoms. This vigilance is crucial to mitigating the risk of diagnostic inaccuracies in these settings. Cases that result in emergency hospitalization at the time of the initial outpatient visit are more likely to have complex or serious patient conditions and more detrimental diagnostic errors.
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