New AHRQ Study Finds Failure to Order Needed Tests a Leading Cause of Diagnostic Errors

AHRQ researchers found that failure to order tests, report results to patients, or follow up with abnormal test findings are leading types of diagnostic errors. Results were based on a survey issued to nearly 300 primary care and specialist physicians who reported 583 cases of diagnosis error, the largest-ever study of diagnostic errors in medicine. Researchers also found that tests were overlooked because clinicians often failed to consider the diagnosis, leading to delays in ordering the tests or making the correct diagnosis. The most common missed or delayed diagnoses include pulmonary embolism, drug reactions or overdose, lung cancer, colorectal cancer, acute coronary syndrome, including heart attack, breast cancer and stroke.

The study, led by Gordon Schiff, M.D., associate director of Brigham and Women's Hospital Center for Patient Safety Research and Practice, Boston, which is part of the Cook County Hospital/Rush University AHRQ-supported Developmental Center for Research in Patient Safety. According to Dr. Schiff, the survey found that other major categories of errors involved failure to consider a diagnosis or overweighing a competing diagnosis, failures in history taking, physical examination, and referral or consultation delays. Findings from the study, "Diagnostic Error in Medicine: Analysis of 583 Physician-Reported Errors," are published in the November 9 issue of the Archives of Internal Medicine.