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Diagnostic Errors Common in Hospitalized Adults Who Die, Move to ICU

23.0 percent experienced a diagnostic error; errors contributed to temporary harm, permanent harm, or death in 17.8 percent

By Elana Gotkine HealthDay Reporter

MONDAY, Jan. 8, 2024 (HealthDay News) — For hospitalized adults who die or are transferred to the intensive care unit (ICU), diagnostic errors are common and are associated with patient harm, according to a study published online Jan. 8 in JAMA Internal Medicine.

Andrew D. Auerbach, M.D., M.P.H., from the University of California in San Francisco, and colleagues examined the prevalence, underlying cause, and harms of diagnostic errors among hospitalized adults transferred to an ICU or who died at 29 academic medical centers in the United States in a retrospective cohort study.

Overall, 23.0 percent of the 2,428 patients whose records underwent review experienced a diagnostic error. The researchers found that in 17.8 percent of patients, errors were judged to have contributed to temporary harm, permanent harm, or death; diagnostic error was judged to have contributed to death in 6.6 percent of the 1,863 patients who died. Patient assessment problems and problems with test ordering and interpretation had the highest opportunity to reduce diagnostic errors in a multivariable model examining process faults associated with any diagnostic error (adjusted proportion attributable fractions, 21.4 and 19.9 percent, respectively).

“Results from our study provide impetus for rapid exploration and testing of interventions seen to reduce diagnostic errors and harms associated with ICU transfers and deaths by targeting gaps in test selection and interpretation and physicians’ ability to debias and rethink diagnoses as high-priority areas,” the authors write.

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