Misdiagnosis: analysis based on case record review with proposals aimed to improve diagnostic processes

Graham Neale*, Helen Hogan, Nick Sevdalis

*Corresponding author for this work

Research output: Contribution to journalLiterature reviewpeer-review

19 Citations (Scopus)

Abstract

Diagnostic error underlies about 10% of adverse events occurring in hospital practice. However, there have been very few studies considering means of improving the mechanisms of diagnosis. As a result, misdiagnosis has been described as 'the next frontier for patient safety'.(1) In this study of case records of patients admitted to hospital as emergencies, some key factors that may underlie diagnostic errors were assessed. From these observations, possibilities for improving the quality of diagnosis and the planning of subsequent care are explored. This paper shows that cognitive biases, believed to distort diagnostic conclusions, can be applied quite specifically to stages in clinical care. These observations led to the proposal of a clinical assessment with a method designed to encourage analytical reasoning. In addition, minor defects in standard practice are shown to adversely influence diagnosis. The findings of this study offer possible means of improving the quality of diagnosis and subsequent patient care, and perhaps pave the way for prospective studies.

Original languageEnglish
Pages (from-to)317-321
Number of pages5
JournalClinical Medicine
Volume11
Issue number4
DOIs
Publication statusPublished - Aug 2011

Keywords

  • analytical reasoning
  • case record review
  • cognitive bias
  • diagnostic error
  • tabulated clinical summary
  • ADVERSE EVENTS
  • INTERNAL-MEDICINE
  • ERRORS
  • SAFETY

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