Diagnostic Error Detection Comes Into Focus
Unless there's an egregious lapse—like an obvious lesion on an MRI that no one noticed—providers move on, and chalk it up to other things: symptom complexity, a sudden surge of evil biochemistry, or something outside the understandable limits of today's physician knowledge.
But if a growing group of physicians and researchers has its way, that attitude will soon change, and there are signs that it already has. There must be a way to measure this gap in care based on an emerging field of science, they say. This developing discipline will find ways to measure efficient accuracy and diagnostic prowess, just as we now scrutinize core measures or surgical outcomes.
Ready for Prime Time?
Hardeep Singh, MD, is a champion of the push to raise misdiagnoses to the realm of quantifiable preventable error. "Fortunately, our field is beginning to attract the attention that we have long hoped for," he wrote in an editorial entitled "Diagnostic Errors: moving beyond no respect and getting ready for prime time," in a October supplement to the British Medical Journal Quality & Safety, which published 10 related articles devoted to the topic.
In an interview this week, Singh, chief of Health Policy, Quality and Informatics at the Houston's Veterans Affairs Center for Innovations in Quality, thinks we're still pretty much in the dark about the extent of the problem, or even how to differentiate a missed diagnostic opportunity from a delayed diagnosis from an outright incorrect conclusion, which may set the patient on an unnecessary and harmful treatment path.
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