Diagnostic Error in Pediatric Cancer

Carberry, Andrea R.; Hanson, Keith; Flannery, Ashley; Fischer, Megan; Gehlbach, Jonathan; Diamond, Carol; Wald, Ellen R.

doi:10.1177/0009922816687325

Cited by 15 publications

(13 citation statements)

References 38 publications

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“…Cancer care can be complex and integrative, as the use of many medications, the tendency for cancer patients to be enrolled in clinical trials, the long follow up time frame, and the involvement of multidisciplinary teams can make it especially challenging for physicians and may add to the risk of medical errors and to the difficulty of disclosing them to patients [27]. Moreover, given the vulnerability of this group, disclosing medical errors to pediatric cancer patients is of a particular challenge, as they may especially face diagnostic delays given the nature of disease in pediatric population [28], chemotherapy infusion errors [29], and outpatient adverse events [30]. Given the complexity of error disclosure in cancer patients, ethical professional practice in KHCC is driven by its six core values of cultural and ethical sensitivity, excellence, compassion, teamwork, innovation, and person-centered care.…”

Section: Introductionmentioning

confidence: 99%

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

et al. 2020

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Background: Between the need for transparency in healthcare, widely promoted by patient's safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option. We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center regarding medical error disclosure. Methods: This is a cross-sectional self-administered questionnaire study. The questionnaire was piloted and no major modifications were made. A day-long training workshop consisting of didactic lectures, short and long case scenarios with role playing and feedback from the instructors, were conducted. Physicians who attended these training workshops were invited to complete the questionnaire at the end of the training, and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments. Descriptive statistics were used to present demographics and KAP. The differences between response\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance. Results: Eighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). Sixty Five percent of physicians were males and the mean number of years of experience was 16.5 years. Eighty-Seven percent (n = 73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan's Law on Medical and Health Liability (66.7% vs 45.5%, p-value = 0.017) and the Law was more likely to affect their decision on error disclosure (61.8% vs 36.4%, p-value = 0.024). Conclusion: Formal training workshops on disclosing medical errors have the power to positively influence physicians' KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the health care system.

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Section: Introductionmentioning

confidence: 99%

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

et al. 2020

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“…Cancer care can be complex and integrative, as the use of many medications, the tendency for cancer patients to be enrolled in clinical trials, the long follow up time frame, and the involvement of multidisciplinary teams can make it especially challenging for physicians and may add to the risk of medical errors and to the di culty of disclosing them to patients [27]. Moreover, given the vulnerability of this group, disclosing medical errors to pediatric cancer patients is of a particular challenge, as they may especially face diagnostic delays given the nature of disease in pediatric population [28], chemotherapy infusion errors [29], and outpatient adverse events [30]. Given the complexity of error disclosure in cancer patients, ethical professional practice in KHCC is driven by its six core values of cultural and ethical sensitivity, excellence, compassion, teamwork, innovation, and person-centered care.…”

Section: Introductionmentioning

confidence: 99%

Disclosure of Medical Errors: Physicians’ Knowledge, Attitudes and Practices (KAP) in an Oncology Center

Mansour

Ammar

Al-Tabba

et al. 2020

Preprint

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Background Between the need for transparency in healthcare, widely promoted by patient’s safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option. We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center regarding medical error disclosure.Methods This is a cross-sectional self-administered questionnaire study. The questionnaire was piloted and no major modifications were made. A day-long training workshop consisting of didactic lectures, short and long case scenarios with role playing and feedback from the instructors, were conducted. Physicians who attended these training workshops were invited to complete the questionnaire at the end of the training, and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments.Descriptive statistics were used to present demographics and KAP. The differences between response\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance. Results Eighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). Sixty Five percent of physicians were males and the mean number of years of experience was 16.5 years. Eighty-Seven percent (n=73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan’s Law on Medical and Health Liability (66.7% vs 45.5%, p-value = 0.017) and the Law was more likely to affect their decision on error disclosure (61.8% vs 36.4%, p-value= 0.024).Conclusion Formal training workshops on disclosing medical errors have the power to positively influence physicians’ KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the health care system.

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“…10 Studies show that the first contact of patients diagnosed with childhood cancer occurred in primary care. [11][12][13][14] During this first contact, the patients were assisted by a physician (68%) or a nurse (32%). 11 However, another study verified that diagnostic errors seem more common in primary care when compared to the diagnosis performed in departments of other levels of the health system.…”

Section: Introductionmentioning

confidence: 99%

“…11 However, another study verified that diagnostic errors seem more common in primary care when compared to the diagnosis performed in departments of other levels of the health system. 12 Professionals involved in primary care should possess a high degree of suspicion as well as excellent physical examination skills in order to improve the chances of an early diagnosis of childhood neoplasms. In addition, these professionals should be adequately informed about the signs and symptoms that may be caused by cancer and where to refer patients to carry out the necessary investigations and treatment.…”

Section: Introductionmentioning

confidence: 99%

<p>Factors Associated with the Detection of Childhood and Adolescent Cancer in Primary Health Care: A Prospective Cross-Sectional Study</p>

Martins

Fernandes

Santos

et al. 2020

JMDH

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Background: The treatment of childhood cancer has achieved important advances evidencing a significant increase in overall survival; however, the diagnosis of these cases still seems late. Among the main causes for the delay in diagnosis are the issues related to the health system and the first professional who performs the care. The objective of this study is to evaluate the knowledge of primary care physicians and nurses about the most common signs and symptoms of pediatric cancers, as well as the factors related to the obtained scores. Methods: This is a prospective cross-sectional study, developed in municipalities in the northeastern region of Brazil. Fifty-one professionals (physicians and nurses) were interviewed through a questionnaire structured as a quiz game about knowledge, training and attitudes regarding the signs and symptoms of childhood cancer. Multiple linear regression analysis was used to evaluate the effect of professional characteristics on the number of correct answers on the implemented questionnaire on knowledge of childhood and adolescent cancer. Results: In the bivariate analysis, the results indicated that the type of employment relationship influences the number of correct answers in the questionnaire used. However, when adjusted for covariates, only the professional category, which means being a medical professional, showed a significant effect on the number of correct answers (β=−7.50, p=0.001). Conclusion: The type of employment relationship of medical professionals and nurses working in primary care had an influence on the number of correct answers for knowledge of childhood and adolescent cancer, but only the professional category (physician) was associated with the highest number when controlled by covariables, thereby justifying the need to improve the curricular training of nurses and greater investments in primary health care for continuing health education that includes infant and adolescent oncology.

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Diagnostic Error in Pediatric Cancer

Cited by 15 publications

References 38 publications

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

Disclosure of Medical Errors: Physicians’ Knowledge, Attitudes and Practices (KAP) in an Oncology Center

<p>Factors Associated with the Detection of Childhood and Adolescent Cancer in Primary Health Care: A Prospective Cross-Sectional Study</p>

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