The challenges in defining and measuring diagnostic error.
The challenges in defining and measuring diagnostic error.
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DOI：
10.1515/dx-2014-0069
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发表时间：
2015-06
期刊：
影响因子：
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通讯作者：
Singh H
中科院分区：
文献类型：
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作者：
Zwaan L;Singh H
诊断错误已经成为一个严重的患者安全问题，但它们很难检测，定义也很复杂。在2013年第六届国际医学诊断错误会议的研究峰会上，我们召集了一个多学科专家小组，讨论在现实世界中定义和测量诊断错误的挑战。在本文中，我们综合了这些讨论，并概述了操作的定义和测量诊断错误的关键研究挑战。这些挑战中的一些包括1）当疾病或诊断随着时间的推移和在不同的护理环境中演变时难以确定错误，2）考虑诊断不足和过度积极的诊断追求之间的平衡，以及3）事后确定疾病诊断可能性和严重性。我们还建立在这些讨论，以描述如何解决这些挑战，同时进行测量诊断错误的研究。
Diagnostic errors have emerged as a serious patient safety problem but they are hard to detect and complex to define. At the research summit of the 2013 Diagnostic Error in Medicine 6th International Conference, we convened a multidisciplinary expert panel to discuss challenges in defining and measuring diagnostic errors in real-world settings. In this paper, we synthesize these discussions and outline key research challenges in operationalizing the definition and measurement of diagnostic error. Some of these challenges include 1) difficulties in determining error when the disease or diagnosis is evolving over time and in different care settings, 2) accounting for a balance between underdiagnosis and overaggressive diagnostic pursuits, and 3) determining disease diagnosis likelihood and severity in hindsight. We also build on these discussions to describe how some of these challenges can be addressed while conducting research on measuring diagnostic error.