Research on Diagnostic Safety and Quality

Since 2007, AHRQ has invested in research to discover findings that advance the knowledge of diagnostic safety and to develop practical tools and resources to improve diagnostic safety. AHRQ funds research to better understand how diagnostic errors happen and what can be done to prevent them.

Research Summit

The September 2016 AHRQ Research Summit on Improving Diagnosis in Health Care explored the state of the science of diagnosis in health care and discussed ways AHRQ and other stakeholders can contribute to a collaborative approach to improving diagnostic performance, as well as identify the research and evidence, tools and training, and data and measures that are needed to improve diagnostic performance.

An article in the June 2017 issue of Diagnosis, authored by members of AHRQ's patient safety team, builds upon themes from the summit by outlining key challenges and areas for potential future research and improvement related to diagnostic errors. Among them are: more robust engagement of patients as an integral part of their health care team; a deeper understanding of diagnostic errors and how to most effectively measure them; successful use of health information technology (IT) to prevent diagnostic error; and structures that optimize how organizations operate and enable better diagnoses for patients.

Studies

AHRQ has funded several recent studies on diagnostic error:

• Outpatient diagnostic errors affect 1 in 20 U.S. adults. This study used data from three previous studies of errors in general primary care diagnosis, colorectal cancer diagnosis, and lung cancer diagnosis. The authors estimated that about half of the diagnostic errors they found could have severely harmed patients.
• Pediatricians self-report an appreciable number of diagnostic errors. This study also finds that pediatricians are most interested in preventing high-frequency, non-life-threatening errors. A third (36%) reported no help in diagnostic error reduction from their electronic health record.
• Additional studies and resources can be found by visiting AHRQ's Patient Safety Network and searching for diagnostic error.

Grants Related to Diagnostic Errors

Grants Awarded in Fiscal Year 2019

Recognizing that all Americans can be affected by diagnostic errors, Congress authorized $2 million in fiscal year 2019 for AHRQ to initiate a research agenda to understand and solve the problem. AHRQ has awarded 4 grants that will more precisely define the scope of diagnostic errors. As stated in the fiscal year 2019 request for applications, AHRQ has three key areas of interest:

• Quantifying the incidence of diagnostic errors.
• Understanding what contributes to these errors.
• Learning more about the link between diagnostic errors and outcomes, including adverse events.

Grants Awarded in Fiscal Year 2022

In fiscal year 2022, Congress authorized funding to support AHRQ's research to address failures in the diagnostic process, which may include the establishment of Research Centers of Diagnostic Excellence to develop systems, measures, and new technology solutions to improve diagnostic safety and quality. In response, AHRQ awarded 10 grants to establish Diagnostic Safety Centers of Excellence. As stated in the fiscal year 2022 request for application, AHRQ specified the four following areas of interest:

• Two areas of focus aligned with frontline diagnostician support:
  • Safety-I error detection and prevention and
  • Safety-II resilience for safe practice.
• Two additional areas of focus aligned with improving diagnostic systems:
  • Improving diagnostic precision through consensus and
  • Improving "truth" or diagnostic reference standards.

Separate grant funding from AHRQ has also supported other diagnostic safety research, including conference grants focused on improving diagnostic safety and quality.