The DOI matches its Crossref record; 113 of the 114 references it cites were found in a registry or an index.
The global burden of diagnostic errors in primary care
Open accessAbstract
Diagnosis is one of the most important tasks performed by primary care physicians. The World Health Organization (WHO) recently prioritized patient safety areas in primary care, and included diagnostic errors as a high-priority problem. In addition, a recent report from the Institute of Medicine in the USA, ‘Improving Diagnosis in Health Care’, concluded that most people will likely experience a diagnostic error in their lifetime. In this narrative review, we discuss the global significance, burden and contributory factors related to diagnostic errors in primary care. We synthesize available literature to discuss the types of presenting symptoms and conditions most commonly affected. We then summarize interventions based on available data and suggest next steps to reduce the global burden of diagnostic errors. Research suggests that we are unlikely to find a ‘magic bullet’ and confirms the need for a multifaceted approach to understand and address the many systems and cognitive issues involved in diagnostic error. Because errors involve many common conditions and are prevalent across all countries, the WHO’s leadership at a global level will be instrumental to address the problem. Based on our review, we recommend that the WHO consider bringing together primary care leaders, practicing frontline clinicians, safety experts, policymakers, the health IT community, medical education and accreditation organizations, researchers from multiple disciplines, patient advocates, and funding bodies among others, to address the many common challenges and opportunities to reduce diagnostic error. This could lead to prioritization of practice changes needed to improve primary care as well as setting research priorities for intervention development to reduce diagnostic error.
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“Since diagnostic processes differ across care settings in terms of workflow, communication needs, and resources, organizational strategies for diagnostic safety should be tailored to each specific setting [373,374].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [374]
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Cites
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Self-citationImproving Diagnosis in Health Care
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Self-citation
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Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-0221-y · Cited by 3,019
The economics of patient safety
Slawomirski, L., Auraaen, A., & Klazinga, N. S. (2017) · OECD health working papers · doi:10.1787/5a9858cd-en · Cited by 645
Improving the accuracy of medical diagnosis with causal machine learning
Richens, J. G., Lee, C. M., & Johri, S. (2020) · Nature Communications · doi:10.1038/s41467-020-17419-7 · Cited by 598
Barnett, M. L., Boddupalli, D., Nundy, S., & Bates, D. W. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.0096 · Cited by 154
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Metadata
- Authors
- Singh, H., Schiff, G. D., Graber, M. L., Onakpoya, I., & Thompson, M. J.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- Brigham and Women's Hospital (US)
- RTI International (US)
- University of Oxford (GB)
- University of Washington (US)
- Corresponding author
- Singh, Hardeep
- Venue
- BMJ Quality & Safety
- Publisher
- BMJ
- Published
- 2016-08-16
- Volume
- 26
- Issue
- 6
- Pages
- 484-494
- ISSN
- 1475-3898 (ISSN-L)
- 2044-5415
- 2044-5423
- PMC
- PMC5502242
- OpenAlex
- W2517618195
- Cited by
- 395
- References
- 114
- Citations by year
- 2026: 30 · 2025: 50 · 2024: 58 · 2023: 52 · 2022: 48 · 2021: 63 · 2020: 45 · 2019: 24 · 2018: 17 · 2017: 5 · 2016: 2
- FWCI
- 19.51
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Quality & Safety (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Health Services Research and Development
- Agency for Healthcare Research and Quality (R21HS023602, R01HS022087)
- VA National Center for Patient Safety
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Keywords
- diagnostic errors, primary care, patient safety, global burden, presenting symptoms, World Health Organization, research priorities, medical education
- MeSH terms
- Clinical Decision-Making, Diagnostic Errors, Education, Medical, Health Policy, Humans, Information Systems, Patient Participation, Primary Health Care, Global Health, World Health Organization, Risk Assessment, Diagnostic Techniques and Procedures, Quality Improvement, Patient Safety
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