Letter to the Editor

Excerpt

We thank Dr. Hamilton for the critique of “Undesirable Diagnostic Events¹ (UDEs),” a concept we recently proposed to advance knowledge on how to standardize the identification of situations with potential diagnostic errors. Dr. Hamilton describes multiple potential confounders influencing the diagnosis of infectious conditions, especially epidemiologic factors and asserts that the heterogeneity of presentation within a given syndrome, such as meningitis, is so broad that comparison of the diagnostic process between centers and countries is likely to be limited. We agree that heterogeneity in the presentation and diagnosis of many conditions could limit widespread applicability. To account for diagnostic processes that vary widely across markedly different health systems and regions, it may be more logical that data about specific UDEs be shared among organizations where disease presentations and diagnostic approaches are similar enough to be validly compared. This can also provide valuable baseline data on the extent of that heterogeneity. …