Document Detail


Errors of diagnosis in pediatric practice: a multisite survey.
MedLine Citation:
PMID:  20566604     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We surveyed pediatricians to elicit their perceptions regarding frequency, contributing factors, and potential system- and provider-based solutions to address diagnostic errors.
METHODS: Academic, community, and trainee pediatricians (N = 1362) at 3 tertiary care institutions and 109 affiliated clinics were invited to complete the survey anonymously through an Internet survey administration service between November 2008 and May 2009.
RESULTS: The overall response rate was 53% (N = 726). More than one-half (54%) of respondents reported that they made a diagnostic error at least once or twice per month; this frequency was markedly higher (77%) among trainees. Almost one-half (45%) of respondents reported diagnostic errors that harmed patients at least once or twice per year. Failure to gather information through history, physical examination, or chart review was the most-commonly reported process breakdown, whereas inadequate care coordination and teamwork was the most-commonly reported system factor. Viral illnesses being diagnosed as bacterial illnesses was the most-commonly reported diagnostic error, followed by misdiagnosis of medication side effects, psychiatric disorders, and appendicitis. Physicians ranked access to electronic health records and close follow-up of patients as strategies most likely to be effective in preventing diagnostic errors.
CONCLUSION: Pediatricians reported making diagnostic errors relatively frequently, and patient harm from these errors was not uncommon.
Authors:
Hardeep Singh; Eric J Thomas; Lindsey Wilson; P Adam Kelly; Kenneth Pietz; Dena Elkeeb; Geeta Singhal
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2010-06-21
Journal Detail:
Title:  Pediatrics     Volume:  126     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-07-28     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  70-9     Citation Subset:  AIM; IM    
Affiliation:
Houston Veterans Affairs Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Attitude of Health Personnel
Child
Child, Preschool
Clinical Competence*
Delayed Diagnosis / statistics & numerical data*
Diagnostic Errors / prevention & control,  statistics & numerical data*
Female
Health Care Surveys
Humans
Incidence
Infant
Linear Models
Male
Needs Assessment
Pediatrics / statistics & numerical data,  trends
Physician's Practice Patterns / statistics & numerical data*,  trends
Population Surveillance
Probability
Questionnaires
Risk Assessment
United States
Grant Support
ID/Acronym/Agency:
K23 CA125585-04/CA/NCI NIH HHS; K23CA125585/CA/NCI NIH HHS
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