AHRQ Views: Blog posts from AHRQ leaders
With Increased Funding, AHRQ To Explore Scope and Causes of Diagnostic Errors
Diagnostic errors include missed and incorrect diagnoses, and also failure to communicate a diagnosis to the patient. They were first identified as a significant type of error in To Err is Human, the 1999 landmark report about patient safety from the Institute of Medicine.
Subsequent research has underscored the troubling prevalence and impacts of diagnostic errors. Improving Diagnosis in Health Care, a 2015 National Academies of Medicine (NAM) report that was funded, in part, by AHRQ included estimates that 1 in 20 U.S. adults experience a diagnostic error each year. Postmortem examinations have shown diagnostic errors were associated with approximately 10 percent of deaths in those patients. And diagnostic errors are the leading type of paid medical malpractice claims.
Recognizing that all Americans can be affected by diagnostic errors, Congress has given $2 million to AHRQ to initiate a research agenda in order to understand and solve the problem. We're beginning this new effort and continuing AHRQ's long-standing commitment to improving diagnostic safety and quality by issuing a funding opportunity announcement to support research that will more precisely define the scope of diagnostic errors. The March 22 announcement outlines 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.
These areas of interest are designed to build on what we already know about diagnostic errors, and help us get a clearer picture of the problem. We intend for the results from these research projects to inform strategies for solving the problem. The funding opportunity is also responsive to the recommendation from the NAM report to commit dedicated funding to implementing a diagnostic safety research agenda.
To make the most of this work, we're encouraging applicants to use electronic health records, patient registries, and other existing data sources. We're also encouraging a multi-disciplinary approach that includes the perspectives of clinicians, health service researchers, data scientists, and other key stakeholders to get a full 360-degree view of the problem. Finally, we encourage applicants to develop partnerships to address data availability and use and formulate analytic questions.
We're hopeful the resulting research will help catalyze productive partnerships and actions that will ultimately improve diagnostic safety.
The new funding announcement addresses the first of two related challenges in diagnostic safety research. First, we want to better understand the full extent of diagnostic errors and where and how those errors are most likely to occur. But simply understanding the scope of the problem isn't sufficient. Once we address the first challenge, we can begin to identify and test solutions in organizations of all types and sizes.
Of course, we already have a promising start about understanding where opportunities and challenges lie.
For example, we know that cardiovascular conditions, cancer, and infections are the "Big 3" categories of disease for which diagnostic errors are most common. Building on what the field already knows will put us all in a better position to apply that knowledge and be successful in solving the problem.
AHRQ has a strong track record in following a path of research that leads to evidence-based solutions. This history, coupled with our early interest and support of diagnostic safety, gives me confidence that emerging research will yield important insights. We look forward to tapping into innovative ideas from the field, and supporting research that will lead to more accurate, timely diagnoses, and ultimately, better patient outcomes.
Dr. Brady is Director of AHRQ's Center for Quality Improvement and Patient Safety.