Diagnostic Delays and Errors in Head and Neck Cancer Patients: Opportunities for Improvement
Abstract
A retrospective review of 100 sequential patients (2009-2012) with head and neck cancer was performed to determine the frequency of 5 types of diagnostic delays and errors outlined by the Institute of Medicine. There were a total of 105 diagnostic delays/errors. The most common was delay in being seen in the otolaryngology clinic after referral placement (28.6%), followed by diagnostic error by the referring physician (22%), delay in referral of a symptomatic patient to the otolaryngology clinic (16.2%), delay in employing an appropriate diagnostic test or procedure (15.2%), delay in action following reporting of pathology or imaging results for an incidental lesion (11.4%), diagnostic error by the otolaryngology clinic (2.8%), delay in action following reporting of pathology or imaging results for the symptomatic lesion (2.8%), and use of outmoded tests or therapy (1%). Increased awareness of these types of delays/errors will direct actions and processes to reduce or eliminate them.
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Diagnostic error research has primarily focused on capturing disease-related factors, including laboratory results, imaging, and treatments, which are easier to extract from medical records.
“Diagnostic error research has primarily focused on capturing disease-related factors [18,19,20,21], including laboratory results, imaging, and treatments, which are easier to extract from medical records.”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [19]
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- Authors
- Franco, J., Elghouche, A. N., Harris, M. S., & Kokoska, M. S.
- Affiliations
- Saint Louis University (US)
- Indiana University School of Medicine (US)
- Aurora Health Care (US)
- Corresponding author
- Franco, Joel
- Venue
- American Journal of Medical Quality
- Published
- 2016-03-30
- Volume
- 32
- Issue
- 3
- Pages
- 330-335
- ISSN
- 1062-8606 (ISSN-L)
- 1555-824X
- OpenAlex
- W2321038174
- Cited by
- 23
- References
- 17
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 1
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Medical Quality (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- head and neck cancer, delayed diagnosis, diagnostic errors, otolaryngology referral, late referral, quality improvement
- MeSH terms
- Diagnostic Errors, Head and Neck Neoplasms, Humans, Otolaryngology, Primary Health Care, Referral and Consultation, Retrospective Studies, Time Factors, United States, United States Department of Veterans Affairs, Delayed Diagnosis
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