Multimorbidity and patient-reported diagnostic errors in the primary care setting: multicentre cross-sectional study in Japan
Multimorbidity and patient-reported diagnostic errors in the primary care setting: multicentre cross-sectional study in Japan
复制标题
初级保健机构中的多发病和患者报告的诊断错误：日本的多中心横断面研究
DOI：
10.1136/bmjopen-2020-039040
复制
发表时间：
2020
期刊：
影响因子：
2.9
通讯作者：
Watanuki Satoshi
中科院分区：
文献类型：
--
作者：
Aoki Takuya;Watanuki Satoshi
目的：目前尚缺乏证据表明多原发性肝癌与诊断错误之间存在联系。从患者的角度了解诊断错误的信息对于改善诊断过程至关重要。在本研究中，我们的目的是调查患者报告的诊断错误，并检查初级保健环境中多发病与患者报告的诊断错误之间的关系。设计多中心横断面研究。设置日本基于初级保健实践的研究网络（25个初级保健机构）。成人门诊患者填写了一份标准化问卷。主要结果测量患者-报告的诊断错误。ResultsData收集1474初级保健门诊病人进行了分析。报告诊断错误的参与者人数为57人（3.9%）。大多数漏诊是初级保健中的常见疾病，如癌症、皮炎和高血压。在调整可能的混杂因素和设施内的聚类后，多发病与患者报告的诊断错误呈正相关（调整后OR=1.83，95%CI 1.01至3.31）。敏感性分析的结果是一致的主要analys.ConclusionsThe本研究显示，在初级保健的诊断错误的经验比在其他国家以前的研究报告的患者比例较低。然而，多发性骨髓瘤患者更有可能报告在初级保健诊断错误，因此，有必要进一步研究，以改善多发性骨髓瘤患者的诊断过程。
ObjectivesThere is lack of evidence for the association between multimorbidity and diagnostic errors. Information on diagnostic errors from patients’ perspectives is crucial to improve the diagnostic process. In this study, we aimed to investigate patient-reported diagnostic errors and to examine the relationship between multimorbidity and patient-reported diagnostic errors in the primary care setting.DesignMulticentre cross-sectional study.SettingA primary care practice-based research network in Japan (25 primary care facilities).ParticipantsAdult outpatients filled out a standardised questionnaire.Primary outcome measurePatient-reported diagnostic errors.ResultsData collected from 1474 primary care outpatients were analysed. The number of participants who reported diagnostic errors was 57 (3.9%). Most of the missed diagnoses were common conditions in primary care, such as cancer, dermatitis and hypertension. After adjustment for possible confounders and clustering within facilities, multimorbidity was positively associated with patient-reported diagnostic errors (adjusted OR=1.83, 95% CI 1.01 to 3.31). The results of the sensitivity analysis were consistent with those of the primary analysis.ConclusionsThe present study showed a lower proportion of patients reporting experiences of diagnostic errors in primary care than those reported in previous studies in other countries. However, patients with multimorbidity are more likely to report diagnostic errors in primary care; thus, further research is necessary to improve the diagnostic process for patients with multimorbidity.
登录
查看更多内容
影响因子：
11.4
作者：
Adams, Robert J.;Tucker, Graeme;Ruffin, Richard E.
通讯作者：
Ruffin, Richard E.
影响因子：
2.9
作者：
Panagioti M;Blakeman T;Hann M;Bower P
通讯作者：
Bower P
影响因子：
39
作者：
Singh, Hardeep;Giardina, Traber Davis;Meyer, Ashley N. D.;Forjuoh, Samuel N.;Reis, Michael D.;Thomas, Eric J.
通讯作者：
Thomas, Eric J.
与一线医疗保健中报告的可预防伤害病例风险增加相关的患者相关因素：病例对照研究
影响因子：
2.9
作者：
R. Fernholm;M. Holzmann;C. Wachtler;R. Szulkin;A. Carlsson;K. Pukk Härenstam
通讯作者：
K. Pukk Härenstam
影响因子：
4.4
作者：
Aoki, Takuya;Yamamoto, Yosuke;Fukuhara, Shunichi
通讯作者：
Fukuhara, Shunichi