Protecting Patients by Reducing Diagnostic Error

Abstract

Almost a decade after the release of "Improving Diagnosis in Health Care," the National Academies of Sciences, Engineering, and Medicine report that highlighted the imperative to improve the diagnostic process in health care, diagnostic errors continue to be a cause of patient harm and death. 1 In JAMA Internal Medicine, Auerbach et al 2 investigated diagnostic errors among hospitalized patients who had experienced a major clinical deterioration, defined as either death or requiring an intensive care unit transfer. Their study of 2428 patient records across 29 academic medical centers in the US found that 23% had experienced a diagnostic error, with 17% of patients experiencing harm or death as a result.While these findings are striking, it is important to highlight that this was a selected sample of the sickest patients in the hospital. Some of these patients may have had poor outcomes regardless of the errors. Subsequent research could incorporate comparison groups of patients who were admitted with similar diagnoses and clinical severity and assess the association between diagnostic error and subsequent outcome.