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Cited by 28Clinical Reasoning and Diagnostic SkillsPatient Safety and Medication ErrorsMedical Coding and Health Information

Clinical Criteria to Screen for Inpatient Diagnostic Errors: A Scoping Review

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Shenvi, Edna C., El-Kareh, Robert·2015·Diagnosis
DOI 10.1515/dx-2014-0047PMC PMC4474234
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Abstract

Diagnostic errors are common and costly, but difficult to detect. “Trigger” tools have promise to facilitate detection, but have not been applied specifically for inpatient diagnostic error. We performed a scoping review to collate all individual “trigger” criteria that have been developed or validated that may indicate that an inpatient diagnostic error has occurred. We searched three databases and screened 8568 titles and abstracts to ultimately include 33 articles. We also developed a conceptual framework of diagnostic error outcomes using real clinical scenarios, and used it to categorize the extracted criteria. Of the multiple criteria we found related to inpatient diagnostic error and amenable to automated detection, the most common were death, transfer to a higher level of care, arrest or “code”, and prolonged length of hospital stay. Several others, such as abrupt stoppage of multiple medications or change in procedure, may also be useful. Validation for general adverse event detection was done in 15 studies, but only one performed validation for diagnostic error specifically. Automated detection was used in only two studies. These criteria may be useful for developing diagnostic error detection tools.

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  • Inpatient and acute care settings commonly use inpatient diagnostic error triggers and EHR-based interventions, whereas outpatient and primary care settings rely more on population risk-stratification tools and ambulatory e-triggers targeting missed follow-up or unexpected ED visits.

    “Inpatient and acute care settings commonly use inpatient diagnostic error triggers [375] and EHR-based interventions [376], whereas outpatient and primary care settings rely more on population risk-stratification tools [377] and ambulatory e-triggers targeting missed follow-up or unexpected ED visits [378].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [375]

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Cited by

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Authors
Shenvi, E. C., & El-Kareh, R.
Affiliations
University of California San Diego (US)
Corresponding author
Shenvi, Edna C.
ORCID
Venue
Diagnosis
Publisher
Walter de Gruyter GmbH
Published
2014-10-18
Volume
2
Issue
1
Pages
3-19
ISSN
  • 2194-8011 (ISSN-L)
  • 2194-802X
DOI
10.1515/dx-2014-0047
PMC
PMC4474234
OpenAlex
W2049124575
Cited by
28
References
1
Citations by year
2026: 1 · 2025: 4 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 5 · 2020: 2 · 2019: 1 · 2018: 6 · 2017: 1 · 2015: 1 · 2014: 1
FWCI
0.13
Type
journal article
Language
en
Open access
Licence
Locations
  • Diagnosis (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • University of California, San Diego
  • U.S. National Library of Medicine (K22LM011435, T15LM011271)
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 › Health Information Management › Medical Coding and Health Information
Keywords
diagnostic errors, inpatient care, trigger tool, adverse event detection, clinical criteria, automated detection, length of hospital stay, patient death, code blue, drug discontinuation

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