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Cited by 259Clinical Reasoning and Diagnostic SkillsPatient Safety and Medication ErrorsMedical Malpractice and Liability Issues

Diagnostic Errors in Medicine: A Case of Neglect

Graber, Mark·2005·The Joint Commission Journal on Quality and Patient Safety
DOI 10.1016/s1553-7250(05)31015-4
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Abstract

Background Medical diagnoses that are wrong, missed, or delayed make up a large fraction of all medical errors and cause substantial suffering and injury. Compared with other types of medical error, however, diagnostic errors receive little attention-a major factor in perpetuating unacceptable rates of diagnostic error. Diagnostic errors are fundamentally obscure, health care organizations have not viewed them as a system problem, and physicians responsible for making medical decisions seldom perceive their own error rates as problematic. The safety of modem health care can be improved if these three issues are understood and addressed. Solutions Opportunities to improve the visibility of diagnostic errors are evident. Diagnostic error needs to be included in the normal spectrum of quality assurance surveillance and review. The system properties that contribute to diagnostic errors need to be systematically identified and addressed, including issues related to reliable diagnostic testing processes. Even for cases entirely dependent on the skill of the clinician for accurate diagnosis, health care organizations could minimize errors by using system-level interventions to aid the clinician, such as second readings of key diagnostic tests and providing resources for clinical decision support. Physicians need to improve their calibration by getting feedback on the diagnoses they make. Finally, clinicians need to learn about overconfidence and other innate cognitive tendencies tha…

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  • The complexity of defining and quantifying diagnostic error shows that this area is largely overlooked in patient safety compared to other quality concerns, including infection, wrong-site surgery, and adverse drug events.

    “The complexity of defining and quantifying diagnostic error shows that this area is largely overlooked in the field of patient safety when compared to other quality concerns, including infection, wrong-site surgery, and adverse drug events [4,6,7].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [7]

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Authors
Graber, M.
Affiliations
United States Department of Veterans Affairs (US)
Corresponding author
Graber, Mark
ORCID
Graber, Mark
Venue
The Joint Commission Journal on Quality and Patient Safety
Publisher
Elsevier BV
Published
2005-02
Volume
31
Issue
2
Pages
106-113
ISSN
1553-7250 (ISSN-L)
DOI
10.1016/s1553-7250(05)31015-4
OpenAlex
W2408123483
Cited by
259
References
4
Citations by year
2026: 3 · 2025: 8 · 2024: 14 · 2023: 7 · 2022: 24 · 2021: 16 · 2020: 13 · 2019: 16 · 2018: 14 · 2017: 15 · 2016: 7 · 2015: 13 · 2014: 14 · 2013: 17 · 2012: 12
FWCI
4.96
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Joint Commission Journal on Quality and Patient Safety (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
  • Health Sciences › Health Professions › Pharmacy › Medical Malpractice and Liability Issues
Keywords
diagnostic errors, medical errors, missed diagnosis, delayed diagnosis, patient safety, second reading, clinical decision support, diagnostic calibration, overconfidence, cognitive biases, system-level interventions
MeSH terms
Diagnostic Errors, Humans, Professional Competence, Quality of Health Care, United States

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