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BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2019

Open Access 01-12-2019 | Research article

Strategies to reduce diagnostic errors: a systematic review

Authors: Julie Abimanyi-Ochom, Shalika Bohingamu Mudiyanselage, Max Catchpool, Marnie Firipis, Sithara Wanni Arachchige Dona, Jennifer J. Watts

Published in: BMC Medical Informatics and Decision Making | Issue 1/2019

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Abstract

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.
Appendix
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Metadata
Title
Strategies to reduce diagnostic errors: a systematic review
Authors
Julie Abimanyi-Ochom
Shalika Bohingamu Mudiyanselage
Max Catchpool
Marnie Firipis
Sithara Wanni Arachchige Dona
Jennifer J. Watts
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2019
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-019-0901-1

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