Evidence map›Paper›PMID 41656886›Full record

ArticleJournal of hospital medicine2026

Incidence, contributing factors, and predictors of diagnostic errors in medical inpatients: A retrospective cohort study.

Caterina E Marx, Elena Hofmann, Martin Perrig, Gurpreet Dhaliwal, Wolf Hautz, Jörg P Isenegger, Ernst Lipp, Drahomir Aujesky, Manuel R Blum, Tobias Tritschler

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In one paragraph

Article in Journal of hospital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

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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

10 authors.

Caterina E MarxDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Elena HofmannDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Martin PerrigDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Gurpreet DhaliwalDepartment of Medicine, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-6134-5913
Wolf HautzDepartment of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Jörg P IseneggerDepartment of Medicine, Hospital Riggisberg, Riggisberg, Switzerland.
Ernst LippDepartment of Medicine, Hospital Aarberg, Aarberg, Switzerland.
Drahomir AujeskyDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Manuel R BlumDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Tobias TritschlerDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Funding

Swiss Society of General Internal Medicine Foundation
6 · The paper itself

Abstract

backgroundDiagnostic error is a major patient safety concern in hospitals, yet most studies have focused on selected high-risk subgroups, leaving the broader general internal medicine inpatient population understudied.

objectivesTo determine the incidence, contributing factors, resulting harm, and predictors of diagnostic error in medical inpatients.

methodsThis retrospective cohort study included adults admitted to internal medicine between 01/2022 and 12/2022 at one tertiary and 4 secondary care hospitals in Switzerland. Retrieved admissions were randomly ordered, and electronic medical records were reviewed sequentially by two clinicians using standardized instruments, until reaching a pre-specified target threshold of 50 patients with ≥1 diagnostic error, enabling analysis of five predictors. The primary outcome was the occurrence of a diagnostic error. The secondary outcome was the resulting level of harm. Five pre-specified predictors were analyzed using multivariable logistic regression.

resultsOf 347 patients (median age 73 [interquartile range, 61-81] years; 140 [40.3%] female), 52 (15%; 95% confidence interval [CI], 11.6%-19.1%) experienced ≥1 diagnostic error, causing harm in 43/52 patients (82.7%; 95% CI 70.3%-90.6%). The most common contributing factors were failures to consider the correct diagnosis (40/52, 76.9%), order appropriate tests (31/52, 59.6%), and act on critical physical exam findings (30/52, 57.7%). Neurocognitive/psychiatric disorders (odds ratio [OR], 2.20; 95% CI, 1.20-4.10) and active cancer (OR, 2.10; 95% CI, 1.01-4.20) independently predicted diagnostic error.

conclusionsDiagnostic error is common among adult medical inpatients and causes harm. We identified neurocognitive/psychiatric disorders and active cancer as patient-level predictors of diagnostic error, providing a basis for future studies on targeted interventions.

Indexed as

Diagnostic ErrorsInpatientsAgedAged, 80 and overCohort StudiesFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk FactorsSwitzerland

Identifiers

PMID41656886
PMCPMC13432594

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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.