| Autor: |
Andrew D. Auerbach, Gopi J. Astik, Kevin J. O’Leary, Peter N. Barish, Molly A. Kantor, Katie R. Raffel, Sumant R. Ranji, Stephanie K. Mueller, Sharran N. Burney, Janice Galinsky, Esteban F. Gershanik, Abhishek Goyal, Pooja R. Chitneni, Sarah Rastegar, Armond M. Esmaili, Cynthia Fenton, Anunta Virapongse, Li-Kheng Ngov, Marisha Burden, Angela Keniston, Hemali Patel, Ashwin B. Gupta, Jeff Rohde, Ruby Marr, S. Ryan Greysen, Michele Fang, Pranav Shah, Frances Mao, Farah Kaiksow, David Sterken, Justin J. Choi, Jigar Contractor, Abhishek Karwa, David Chia, Tiffany Lee, Colin C. Hubbard, Judith Maselli, Anuj K. Dalal, Jeffrey L. Schnipper |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of general internal medicine, vol 38, iss 8 |
| Popis: |
Background The COVID-19 pandemic required clinicians to care for a disease with evolving characteristics while also adhering to care changes (e.g., physical distancing practices) that might lead to diagnostic errors (DEs). Objective To determine the frequency of DEs and their causes among patients hospitalized under investigation (PUI) for COVID-19. Design Retrospective cohort. Setting Eight medical centers affiliated with the Hospital Medicine ReEngineering Network (HOMERuN). Target population Adults hospitalized under investigation (PUI) for COVID-19 infection between February and July 2020. Measurements We randomly selected up to 8 cases per site per month for review, with each case reviewed by two clinicians to determine whether a DE (defined as a missed or delayed diagnosis) occurred, and whether any diagnostic process faults took place. We used bivariable statistics to compare patients with and without DE and multivariable models to determine which process faults or patient factors were associated with DEs. Results Two hundred and fifty-seven patient charts underwent review, of which 36 (14%) had a diagnostic error. Patients with and without DE were statistically similar in terms of socioeconomic factors, comorbidities, risk factors for COVID-19, and COVID-19 test turnaround time and eventual positivity. Most common diagnostic process faults contributing to DE were problems with clinical assessment, testing choices, history taking, and physical examination (all p Limitations Results are limited by available documentation and do not capture communication between providers and patients. Conclusion Among PUI patients, DEs were common and not associated with pandemic-related care changes, suggesting the importance of more general diagnostic process gaps in error propagation. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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