A recent issue of the BMJ Quality and Safety carried an interesting review on the global burden of diagnostic errors in primary care. The review looked at the most common symptoms and conditions affected by such errors; summarised the current interventions; and suggested what could be done next to reduce the global burden of diagnostic errors. The authors found that:
- Typically there are multiple ‘root causes’ for errors, including both cognitive errors, such as failing to synthesise evidence, and system flaws, such as communication issues.
- The most common categories of harmful diagnostic errors are infections, cardiovascular disease, cancer, and diseases in children.
- Very few interventions to reduce errors have been tested empirically.
- In order to reduce errors successfully there is likely to be a need for multiple interventions.
They go on to propose eight themes for interventions to measure and reduce diagnostic error:
- Improving diagnostic reasoning.
- Encouraging government policies that support primary care.
- Improving information technology.
- Involving patients.
- Improving access to diagnostic tests.
- Developing methods to identify and learn from diagnostic errors.
- Optimising diagnostic strategies in primary care.
- Providing systematic feedback to clinicians about their diagnoses.
The authors call on the World Health Organization to bring together concerned bodies to address the many challenges that are common across all countries and the opportunities that can be taken to reduce diagnostic error. CLAHRC WM collaborators are working on a more detailed classification system for the theoretical basis for diagnostic error.
— Peter Chilton, Research Fellow
- Singh H, Schiff GD, Graber ML, Onakpoya I, Thompson MJ. The global burden of diagnostic errors in primary care. BMJ Qual Saf. 2017; 26: 484-94.