Strategies to reduce diagnostic errors: a systematic review
| Autor: | Jennifer J. Watts, Julie Abimanyi-Ochom, Shalika Bohingamu Mudiyanselage, Marnie Firipis, Sithara Wanni Arachchige Dona, Max Catchpool |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
020205 medical informatics Psychological intervention MEDLINE Health Informatics 02 engineering and technology Audit lcsh:Computer applications to medicine. Medical informatics Health informatics law.invention Communication strategies 03 medical and health sciences Patient safety 0302 clinical medicine Randomized controlled trial law Acute care 0202 electrical engineering electronic engineering information engineering Medicine Humans 030212 general & internal medicine Diagnostic Errors business.industry Health Policy medicine.disease Computer Science Applications Diagnostic error Clinical setting Data extraction lcsh:R858-859.7 Medical emergency business Research Article |
| Zdroj: | BMC Medical Informatics and Decision Making BMC Medical Informatics and Decision Making, Vol 19, Iss 1, Pp 1-14 (2019) |
| ISSN: | 1472-6947 |
| Popis: | Background To evaluate the effectiveness of audit and communication strategies to reduce diagnostic errors made by clinicians. Methods MEDLINE complete, CINHAL complete, EMBASE, PSNet and Google Advanced. Electronic and manual search of articles on audit systems and communication strategies or interventions, searched for papers published between January 1990 and April 2017. We included studies with interventions implemented by clinicians in a clinical environment with real patients. Results A total of 2431 articles were screened of which 26 studies met inclusion criteria. Data extraction was conducted by two groups, each group comprising two independent reviewers. Articles were classified by communication (6) or audit strategies (20) to reduce diagnostic error in clinical settings. The most common interventions were delivered as technology-based systems n = 16 (62%) and within an acute care setting n = 15 (57%). Nine studies reported randomised controlled trials. Three RCT studies on communication interventions and 3 RCTs on audit strategies found the interventions to be effective in reducing diagnostic errors. Conclusion Despite numerous studies on interventions targeting diagnostic errors, our analyses revealed limited evidence on interventions being practically used in clinical settings and a bias of studies originating from the US (n = 19, 73% of included studies). There is some evidence that trigger algorithms, including computer based and alert systems, may reduce delayed diagnosis and improve diagnostic accuracy. In trauma settings, strategies such as additional patient review (e.g. trauma teams) reduced missed diagnosis and in radiology departments review strategies such as team meetings and error documentation may reduce diagnostic error rates over time. Trial registration The systematic review was registered in the PROSPERO database under registration number CRD42017067056. Electronic supplementary material The online version of this article (10.1186/s12911-019-0901-1) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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