Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI

Abstract Background To investigate diagnostic errors and their association with adverse outcomes (AOs) during patient revisits with repeat imaging (RVRIs) in the emergency department (ED). Results Diagnostic errors stemming from index imaging studies and AOs within 30 days in 1054 RVRIs (≤ 7 days) f...

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Autores principales:	Yura Ahn, Gil-Sun Hong, Kye Jin Park, Choong Wook Lee, Ju Hee Lee, Seon-Ok Kim
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Emergency health services Diagnostic imaging Diagnostic errors Quality indicators Adverse outcomes Medical physics. Medical radiology. Nuclear medicine R895-920
Acceso en línea:	https://doaj.org/article/753e6c45ddc14c61b7e238263c855447
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spelling	oai:doaj.org-article:753e6c45ddc14c61b7e238263c8554472021-11-07T12:14:38ZImpact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI10.1186/s13244-021-01108-01869-4101https://doaj.org/article/753e6c45ddc14c61b7e238263c8554472021-11-01T00:00:00Zhttps://doi.org/10.1186/s13244-021-01108-0https://doaj.org/toc/1869-4101Abstract Background To investigate diagnostic errors and their association with adverse outcomes (AOs) during patient revisits with repeat imaging (RVRIs) in the emergency department (ED). Results Diagnostic errors stemming from index imaging studies and AOs within 30 days in 1054 RVRIs (≤ 7 days) from 2005 to 2015 were retrospectively analyzed according to revisit timing (early [≤ 72 h] or late [> 72 h to 7 days] RVRIs). Risk factors for AOs were assessed using multivariable logistic analysis. The AO rate in the diagnostic error group was significantly higher than that in the non-error group (33.3% [77 of 231] vs. 14.8% [122 of 823], p < .001). The AO rate was the highest in early revisits within 72 h if diagnostic errors occurred (36.2%, 54 of 149). The most common diseases associated with diagnostic errors were digestive diseases in the radiologic misdiagnosis category (47.5%, 28 of 59) and neurologic diseases in the delayed radiology reporting time (46.8%, 29 of 62) and clinician error (27.3%, 30 of 110) categories. In the matched set of the AO and non-AO groups, multivariable logistic regression analysis revealed that the following diagnostic errors contributed to AO occurrence: radiologic error (odds ratio [OR] 3.56; p < .001) in total RVRIs, radiologic error (OR 3.70; p = .001) and clinician error (OR 4.82; p = .03) in early RVRIs, and radiologic error (OR 3.36; p = .02) in late RVRIs. Conclusion Diagnostic errors in index imaging studies are strongly associated with high AO rates in RVRIs in the ED.Yura AhnGil-Sun HongKye Jin ParkChoong Wook LeeJu Hee LeeSeon-Ok KimSpringerOpenarticleEmergency health servicesDiagnostic imagingDiagnostic errorsQuality indicatorsAdverse outcomesMedical physics. Medical radiology. Nuclear medicineR895-920ENInsights into Imaging, Vol 12, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Emergency health services Diagnostic imaging Diagnostic errors Quality indicators Adverse outcomes Medical physics. Medical radiology. Nuclear medicine R895-920
spellingShingle	Emergency health services Diagnostic imaging Diagnostic errors Quality indicators Adverse outcomes Medical physics. Medical radiology. Nuclear medicine R895-920 Yura Ahn Gil-Sun Hong Kye Jin Park Choong Wook Lee Ju Hee Lee Seon-Ok Kim Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI
description	Abstract Background To investigate diagnostic errors and their association with adverse outcomes (AOs) during patient revisits with repeat imaging (RVRIs) in the emergency department (ED). Results Diagnostic errors stemming from index imaging studies and AOs within 30 days in 1054 RVRIs (≤ 7 days) from 2005 to 2015 were retrospectively analyzed according to revisit timing (early [≤ 72 h] or late [> 72 h to 7 days] RVRIs). Risk factors for AOs were assessed using multivariable logistic analysis. The AO rate in the diagnostic error group was significantly higher than that in the non-error group (33.3% [77 of 231] vs. 14.8% [122 of 823], p < .001). The AO rate was the highest in early revisits within 72 h if diagnostic errors occurred (36.2%, 54 of 149). The most common diseases associated with diagnostic errors were digestive diseases in the radiologic misdiagnosis category (47.5%, 28 of 59) and neurologic diseases in the delayed radiology reporting time (46.8%, 29 of 62) and clinician error (27.3%, 30 of 110) categories. In the matched set of the AO and non-AO groups, multivariable logistic regression analysis revealed that the following diagnostic errors contributed to AO occurrence: radiologic error (odds ratio [OR] 3.56; p < .001) in total RVRIs, radiologic error (OR 3.70; p = .001) and clinician error (OR 4.82; p = .03) in early RVRIs, and radiologic error (OR 3.36; p = .02) in late RVRIs. Conclusion Diagnostic errors in index imaging studies are strongly associated with high AO rates in RVRIs in the ED.
format	article
author	Yura Ahn Gil-Sun Hong Kye Jin Park Choong Wook Lee Ju Hee Lee Seon-Ok Kim
author_facet	Yura Ahn Gil-Sun Hong Kye Jin Park Choong Wook Lee Ju Hee Lee Seon-Ok Kim
author_sort	Yura Ahn
title	Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI
title_short	Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI
title_full	Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI
title_fullStr	Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI
title_full_unstemmed	Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI
title_sort	impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat ct or mri
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/753e6c45ddc14c61b7e238263c855447
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Impact of diagnostic errors on adverse outcomes: learning from emergency department revisits with repeat CT or MRI

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