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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 462 Research Studies Displayed
Lowry KP, Bissell MCS, Miglioretti DL
Breast biopsy recommendations and breast cancers diagnosed during the COVID-19 pandemic.
The authors sought to examine breast biopsy recommendations and breast cancers diagnosed before and during the COVID-19 pandemic by mode of detection and women's characteristics. Using data from the Breast Cancer Surveillance Consortium, they found that there were substantially fewer breast biopsies with cancer diagnoses during the COVID-19 pandemic from March to September 2020 compared to the same period in 2019, with Asian and Hispanic women experiencing the largest declines followed by Black women.
Citation: Lowry KP, Bissell MCS, Miglioretti DL . Breast biopsy recommendations and breast cancers diagnosed during the COVID-19 pandemic. Radiology 2022 May;303(2):287-94. doi: 10.1148/radiol.2021211808..
Keywords: COVID-19, Cancer: Breast Cancer, Cancer, Diagnostic Safety and Quality
Starnes LS, Krehnbrink M, Carroll AR
A pain in the neck: an adolescent with neck pain.
This case study involves a 15-year-old boy who presents with several years of intermittent neck pain, which has acutely worsened during the past 4 days. Patient history, diagnosis (Salmonella osteomyelitis.), and treatment are explored.
Citation: Starnes LS, Krehnbrink M, Carroll AR . A pain in the neck: an adolescent with neck pain. Pediatr Rev 2022 Mar;43(3):174-77. doi: 10.1542/pir.2020-004168..
Keywords: Children/Adolescents, Infectious Diseases, Diagnostic Safety and Quality, Case Study, Evidence-Based Practice
Woloshin S, Dewitt B, Krishnamurti T
Assessing how consumers interpret and act on results from at-home COVID-19 self-test kits: a randomized clinical trial.
The US Food and Drug Administration (FDA) authorized SARS-CoV-2 rapid at-home self-test kits for individuals with and without symptoms. How appropriately users interpret and act on the results of at-home COVID-19 self-tests is unknown. The objective of this study was to assess how users of at-home COVID-19 self-test kits interpreted and acted on results when given instructions authorized by the FDA, instructions based on decision science principles, or no instructions.
Citation: Woloshin S, Dewitt B, Krishnamurti T . Assessing how consumers interpret and act on results from at-home COVID-19 self-test kits: a randomized clinical trial. JAMA Intern Med 2022 Mar;182(3):332-41. doi: 10.1001/jamainternmed.2021.8075..
Keywords: COVID-19, Diagnostic Safety and Quality
Lacson R, Khorasani R, Fiumara K
Collaborative case review: a systems-based approach to patient safety event investigation and analysis.
The objectives of this study were to assess a system-based approach to event investigation and analysis--collaborative case reviews (CCRs)--and to measure impact of clinical specialty on strength of action items prescribed. The institutional review board-approved study describes the program, including a percentage of CCR from an institutional Electronic Safety Reporting System. Findings showed that an integrated multispecialty CCR co-led by the radiology department and an institutional patient safety program was associated with a higher proportion of CCR, stronger action items, and higher action item completion rate versus other hospital departments.
Citation: Lacson R, Khorasani R, Fiumara K . Collaborative case review: a systems-based approach to patient safety event investigation and analysis. J Patient Saf 2022 Mar 1;18(2):e522-e27. doi: 10.1097/pts.0000000000000857..
Keywords: Patient Safety, Adverse Events, Diagnostic Safety and Quality, Imaging
Radhakrishnan A, Reyes-Gastelum D, Abrahamse P
Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities.
The authors sought to characterize providers involved in diagnosing and treating thyroid cancer. Patients with differentiated thyroid cancer from the Georgia and Los Angeles County Surveillance, Epidemiology and End Results registries were surveyed. The authors found that, among thyroid cancer patients, 40.6% reported being informed of their diagnosis by their surgeon, 37.9% by their endocrinologist, and 13.5% by their primary care physician (PCP). The researchers concluded that PCPs were involved in thyroid cancer diagnosis and treatment, and their involvement was greater among older patients and patients of minority race/ethnicity.
Citation: Radhakrishnan A, Reyes-Gastelum D, Abrahamse P . Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities. J Clin Endocrinol Metab 2022 Feb 17;107(3):e1096-e105. doi: 10.1210/clinem/dgab781..
Keywords: Cancer, Disparities, Diagnostic Safety and Quality, Practice Patterns, Quality Improvement, Quality of Care
Bryant KB, Green MB, Shimbo D
Home blood pressure monitoring for hypertension diagnosis by current recommendations: a long way to go.
This analysis examined how historical use of home blood pressure monitoring (HBPM) aligns with current out-of-office BP monitoring recommendations for hypertensive US adults without a previous hypertension diagnosis and how HBPM use varies by patient characteristics. A cohort of 7185 adults aged 20 years or older without a diagnosis of hypertension or antihypertensive medication use and a high office BP (≥130/80 mm Hg) who participated in the National Health and Nutrition Examination Survey (NHANES) 2009 to 2014 cycle were included. Participants who answered as having self-initiated or physician recommended HBPM were categorized as having used or having been told to use HBPM. The authors estimate that 31.4 million US adults did not have diagnosed hypertension, were not taking antihypertensive medications, and had an office BP ≥130/80 mm Hg. Out of that population, 95.3% would have met criteria to undergo out-of-office BP monitoring by the American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Only 3.6% (1.1 million) were told to use HBPM, and 15.7% had used HPBM. There were no differences in use by race/ethnicity, sex, health insurance status, or source of routine healthcare. The authors suggest the use of a telemonitoring system to improve ease of HBPM.
Citation: Bryant KB, Green MB, Shimbo D . Home blood pressure monitoring for hypertension diagnosis by current recommendations: a long way to go. Hypertension 2022 Feb;79(2):e15-e17. doi: 10.1161/hypertensionaha.121.18463..
Keywords: Hypertension, Diagnostic Safety and Quality, Blood Pressure
Marchese AL, Fine AM, Levy JA
Physician risk perception and testing behaviors for children with fever.
This study sought to determine whether physician risk perception was associated with the decision to obtain blood or imaging tests among children who present to the emergency department with fever. A retrospective, cross-section study was conducted at the Boston Children’s Hospital emergency department. Children aged 6 months to 18 years who presented with a fever from May 2014 to April 2019 were included. The authors assessed risk perception using 3 scales: the Risk Tolerance Scale (RTS), Stress from Uncertainty Scale (SUS), and Malpractice Fear Scale (MFS). Across 55 pediatric emergency physicians, there was no association found between risk perception and blood/imaging testing in febrile children for any of those scales.
Citation: Marchese AL, Fine AM, Levy JA . Physician risk perception and testing behaviors for children with fever. Pediatr Emerg Care 2022 Feb;38(2):e805-e10. doi: 10.1097/pec.0000000000002413..
Keywords: Children/Adolescents, Provider: Physician, Emergency Department, Diagnostic Safety and Quality
Kho RM, Desai VB, Schwartz PE
Endometrial sampling for preoperative diagnosis of uterine leiomyosarcoma.
This retrospective cohort study examined the effectiveness of endometrial sampling for preoperative detection of uterine leiomyosarcoma in women undergoing hysterectomy, identified factors associated with missed diagnosis, and compared the outcomes of patients who had a preoperative diagnosis with those patients who had a missed diagnosis. A total of 79 patients with uterine leiomyosarcoma were included in the study. Of those patients, 46 (58.2%) were diagnosed preoperatively and 33 postoperatively. The groups were similar in age, race/ethnicity, bleeding symptoms, and comorbidities. Women who had endometrial sampling performed with hysteroscopy had a higher likelihood of preoperative diagnosis. Patients with localized stage (vs distant stage) or tumor size >11 cm were less likely to be diagnosed preoperatively.
Citation: Kho RM, Desai VB, Schwartz PE . Endometrial sampling for preoperative diagnosis of uterine leiomyosarcoma. J Minim Invasive Gynecol 2022 Jan;29(1):119-27. doi: 10.1016/j.jmig.2021.07.004.
Keywords: Cancer, Diagnostic Safety and Quality, Surgery, Women
Zimolzak AJ, Shahid U, Giardina TD
Why test results are still getting "lost" to follow-up: a qualitative study of implementation gaps.
Lack of timely follow-up of abnormal test results is common and has been implicated in missed or delayed diagnosis, resulting in potential for patient harm. As part of a larger project to implement change strategies to improve follow-up of diagnostic test results, this study sought to identify specifically where implementation gaps exist, as well as possible solutions identified by front-line staff.
Citation: Zimolzak AJ, Shahid U, Giardina TD . Why test results are still getting "lost" to follow-up: a qualitative study of implementation gaps. J Gen Intern Med 2022 Jan;37(1):137-44. doi: 10.1007/s11606-021-06772-y..
Keywords: Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care
Mahajan P, Mollen C, Alpern ER
An operational framework to study diagnostic errors in emergency departments: findings from a consensus panel.
The purpose of this study was to create an operational definition and framework to study diagnostic error in the emergency department setting. A multidisciplinary panel defined diagnostic errors, modified the National Academies of Sciences, Engineering, and Medicine's diagnostic process framework, and underscored the importance of outcome feedback to emergency department providers to promote learning and improvement related to diagnosis.
Citation: Mahajan P, Mollen C, Alpern ER . An operational framework to study diagnostic errors in emergency departments: findings from a consensus panel. J Patient Saf 2021 Dec 1;17(8):570-75. doi: 10.1097/pts.0000000000000624..
Keywords: Diagnostic Safety and Quality, Emergency Department, Medical Errors, Adverse Events
Tremblay ES, Millington K, Monuteaux MC
Plasma β-Hydroxybutyrate for the diagnosis of diabetic ketoacidosis in the emergency department.
Diabetic ketoacidosis (DKA) is a common emergency department presentation of both new-onset and established diabetes mellitus (DM). β-Hydroxybutyrate (BOHB) provides a direct measure of the pathophysiologic derangement in DKA as compared with the nonspecific measurements of blood pH and bicarbonate. The objective of this study was to characterize the relationship between BOHB and DKA. The investigators concluded that β-Hydroxybutyrate accurately predicted DKA in children and adolescents. More importantly, because plasma BOHB is the ideal biochemical marker of DKA, BOHB may provide a more optimal definition of DKA for management decisions and treatment targets.
Citation: Tremblay ES, Millington K, Monuteaux MC . Plasma β-Hydroxybutyrate for the diagnosis of diabetic ketoacidosis in the emergency department. Pediatr Emerg Care 2021 Dec;37(12):e1345-e50. doi: 10.1097/pec.0000000000002035..
Keywords: Children/Adolescents, Emergency Department, Diabetes, Diagnostic Safety and Quality
Giardina TD, Korukonda S, Shahid U
Use of patient complaints to identify diagnosis-related safety concerns: a mixed-method evaluation.
This retrospective cohort study evaluated the use of patient complaint data to identify patient safety concerns related to diagnosis as an initial step to using this information to facilitate learning and improvement. Patient complaints submitted to the Geisinger healthcare system were reviewed with 2 cohorts from August to December 2017 (cohort 1) and January to June 2018 (cohort 2). The authors selected complaints more likely to be associated with diagnostic concerns in Geisinger’s existing complaint taxonomy. In cohort 1, 1865 complaint summaries were reviewed and 177 (9.5%) were identified as concerning. The review identified 39 diagnostic errors. In cohort 2, 2423 patient complaints were reviewed and 310 (12.8%) concerning reports were identified. A 10% sample contained give diagnostic errors. Most errors were categorized as “Clinical Care” issues.
AHRQ-funded; HS025474; HS027363.
Citation: Giardina TD, Korukonda S, Shahid U . Use of patient complaints to identify diagnosis-related safety concerns: a mixed-method evaluation. BMJ Qual Saf 2021 Dec;30(12):996-1001. doi: 10.1136/bmjqs-2020-011593..
Keywords: Diagnostic Safety and Quality, Patient Safety, Medical Errors, Adverse Events
Nehls N, Yap TS, Salant T
Systems engineering analysis of diagnostic referral closed-loop processes.
This systems engineering (SE) analysis of diagnostic referral closed-loop processes examines process logic, variation, reliability, and failures for completing diagnostic referrals originating in two primary care practices serving different demographics, using dermatology as an illustrating use case. Research has shown that there is a 65-73% failure rate in completing diagnostic referrals, which is a significant patient safety problem. An interdisciplinary team collaborated to understand processes of initiating and completing diagnostic referrals. Cross-functional process maps were developed through iterative group interviews with an urban community-based health center and a teaching practice within a large academic medical center. Results were used to conduct an engineering process analysis, assess variation between and within practices, and identify common failure modes and potential solutions.
Citation: Nehls N, Yap TS, Salant T . Systems engineering analysis of diagnostic referral closed-loop processes. BMJ Open Qual 2021 Nov;10(4). doi: 10.1136/bmjoq-2021-001603..
Keywords: Diagnostic Safety and Quality, Primary Care, Patient Safety
Daniel M, Park S, Seifert CM
Understanding diagnostic processes in emergency departments: a mixed methods case study protocol.
This paper describes a study protocol to map diagnostic processes in the emergency department as a foundation for developing future error mitigation strategies. The study has three parts: prospective field observations of patients with undifferentiated symptoms at high risk for diagnostic error; observing individual care team providers over a 4-hour window; and interviews with key stakeholders to understand different perspectives on the diagnostic process. This foundational work will help identify strengths and vulnerabilities in diagnostic processes.
AHRQ-funded; HS027363; HS026622.
Citation: Daniel M, Park S, Seifert CM . Understanding diagnostic processes in emergency departments: a mixed methods case study protocol. BMJ Open 2021 Sep 24;11(9):e044194. doi: 10.1136/bmjopen-2020-044194..
Keywords: Emergency Department, Diagnostic Safety and Quality
Vaghani V, Wei L, U
Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments.
Diagnostic errors are major contributors to preventable patient harm. In this study, the investigators validated the use of an electronic health record (EHR)-based trigger (e-trigger) to measure missed opportunities in stroke diagnosis in emergency departments (EDs). The investigators concluded that a symptom-disease pair-based e-trigger identified missed diagnoses of stroke with a modest positive predictive value, underscoring the need for chart review validation procedures to identify diagnostic errors in large data sets.
AHRQ-funded; HS017820; HS024459.
Citation: Vaghani V, Wei L, U . Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments. J Am Med Inform Assoc 2021 Sep 18;28(10):2202-11. doi: 10.1093/jamia/ocab121..
Keywords: Stroke, Cardiovascular Conditions, Emergency Department, Diagnostic Safety and Quality, Medical Errors, Adverse Events
Bucher BT, Yang M, Arndorfer J
Changes in the accuracy of administrative data for the detection of surgical site infections.
The authors performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. They found no significant change in the accuracy of these codes following the transition from ICD-CM ninth edition to tenth edition codes.
Citation: Bucher BT, Yang M, Arndorfer J . Changes in the accuracy of administrative data for the detection of surgical site infections. Infect Control Hosp Epidemiol 2021 Sep;42(9):1128-30. doi: 10.1017/ice.2020.1346..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Diagnostic Safety and Quality
Hua CL, Thomas KS, Bunker J
Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia.
The objective of this study was to examine the agreement between a clinical Minimum Data Set measure of dementia and a diagnosis of dementia documented on a hospital claim across three points in time. A second objective was to examine the extent to which the agreement varied by age, sex, and race/ethnicity. Findings showed that hospital claims for patients aged 66–75 were less likely to be accurate than those for other age groups and suggests that physicians do not always look for signs of dementia in younger adults. Additionally, Asian patients were less likely to have a diagnosis of dementia documented during hospitalization, which could be related to language barriers between patients and clinicians.
Citation: Hua CL, Thomas KS, Bunker J . Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia. J Am Geriatr Soc 2021 Sep;69(9):2672-75. doi: 10.1111/jgs.17201..
Keywords: Elderly, Dementia, Neurological Disorders, Diagnostic Safety and Quality, Medicare
Miller AC, Koeneman SH, Arakkal AT
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
This retrospective cohort study determined the frequency and duration of diagnostic delays for herpes simplex encephalitis (HSE) that are associated with increased morbidity and mortality. Data from the IBM Marketscan Databases from 2001-2017 was used. The authors estimated the number of visits with HSE-related symptoms before diagnosis that would be expected to occur in the absence of delays and compared this estimate to the observed pattern of visits. Then a simulation-based approach was used to compute the number of visits representing a delay. They identified 2667 patients diagnosed with HSE and estimated 45.9% of patients experienced at least 1 missed opportunity, with 21.9% of patients having delays lasting >7 days. Risk factors for delays included being seen only in the emergency department, age 65 or older, or a history of sinusitis or schizophrenia.
Citation: Miller AC, Koeneman SH, Arakkal AT . Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study. Open Forum Infect Dis 2021 Sep;8(9):ofab400. doi: 10.1093/ofid/ofab400..
Keywords: Infectious Diseases, Neurological Disorders, Diagnostic Safety and Quality, Risk
Goyal MK, Chamberlain JM, Webb M
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
The objective of this 3-year multicenter retrospective cohort study of children was to determine if there are race/ethnicity differences in rates of appendiceal perforation, delayed diagnosis of appendicitis, and diagnostic imaging during prior visit(s). Delayed diagnosis was defined as having at least one emergency department (ED) visit within 7 days preceding the appendicitis diagnosis. Out of 7,298 patients diagnosed with appendicitis and documented race/ethnicity, 2,567 had appendiceal perforation. Non-Hispanic (NH) Black children had a higher likelihood of perforation (36.5% versus 34.9%) then non-Hispanic whites. They also were over twice as likely to have delayed diagnosis (4.7% versus 2.0%). Eighty-nine patients (43.2%) patients with delayed diagnosis had abdominal imaging during the prior visits. However, NH-Black children were less likely to have any imaging (28.2% versus 46.2%) or definitive imaging (10.3% versus 35.9%).
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142.
Citation: Goyal MK, Chamberlain JM, Webb M . Racial and ethnic disparities in the delayed diagnosis of appendicitis among children. Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142..
Keywords: Children/Adolescents, Racial / Ethnic Minorities, Disparities, Diagnostic Safety and Quality
Kuhn J, Levinson Udhnani, MD
What happens after a positive primary care autism screen among historically underserved families? Predictors of evaluation and autism diagnosis.
This study examined predictors of receiving a recommended diagnostic evaluation after a recommended primary care-administered autism screen, and of those who screen positive, who is most likely to be diagnosed with autism. Participants were 309 predominantly low-income, racial/ethnic minority parents and their child aged 15-27 months who screened positive with the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F). Significant predictors of diagnostic evaluation included older parental age, being non-Hispanic and the child having private insurance, lower child communication functioning, or receiving Early Intervention services. Significant predictors of an autism diagnosis included being male, having lower child communication functioning, screening directly in the parent’s preferred language, White/non-Hispanic parent, and no parent history of mood disorder.
Citation: Kuhn J, Levinson Udhnani, MD . What happens after a positive primary care autism screen among historically underserved families? Predictors of evaluation and autism diagnosis. J Dev Behav Pediatr 2021 Sep;42(7):515-23. doi: 10.1097/dbp.0000000000000928..
Keywords: Children/Adolescents, Autism, Screening, Vulnerable Populations, Diagnostic Safety and Quality
Mahajan P, Pai CW, Cosby KS
Identifying trigger concepts to screen emergency department visits for diagnostic errors.
The diagnostic process is a vital component of safe and effective emergency department (ED) care. There are no standardized methods for identifying or reliably monitoring diagnostic errors in the ED, impeding efforts to enhance diagnostic safety. In this study, the investigators sought to identify trigger concepts to screen ED records for diagnostic errors and describe how they can be used as a measurement strategy to identify and reduce preventable diagnostic harm.
AHRQ-funded; HS024953; HS027363.
Citation: Mahajan P, Pai CW, Cosby KS . Identifying trigger concepts to screen emergency department visits for diagnostic errors. Diagnosis 2021 Aug 26;8(3):340-46. doi: 10.1515/dx-2020-0122..
Keywords: Emergency Department, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety
Michelson KA, Reeves SD, Grubenhoff JA
Clinical features and preventability of delayed diagnosis of pediatric appendicitis.
In this case-control study, researchers sought to determine clinical features associated with delayed diagnosis of pediatric appendicitis, to assess the frequency of preventable delay, and to compare delay outcomes. They found that delayed appendicitis was associated with initially milder symptoms but worse outcomes. Their findings suggest that a majority of delayed diagnoses were at least possibly preventable and that many of the studied patients did not undergo indicated imaging, suggesting an opportunity to prevent delayed diagnosis of appendicitis in some children.
Citation: Michelson KA, Reeves SD, Grubenhoff JA . Clinical features and preventability of delayed diagnosis of pediatric appendicitis. JAMA Netw Open 2021 Aug;4(8):e2122248. doi: 10.1001/jamanetworkopen.2021.22248..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Prevention
Cifra CL, Custer JW, Singh H
Diagnostic errors in pediatric critical care: a systematic review.
This study is a systematic review on the prevalence, impact, and contributing factors related to diagnostic errors in the PICU. A database search was done for literature up through December 2019. Using specific criteria, 396 abstracts were screened, and 17 studies were included. Fifteen of 17 studies had an observational research design. Autopsy studies showed a 10-23% rate of missed major diagnosis with 5-16% of the errors having a potential adverse impact on survival and would have changed care management. Retrospective record review studies reported varying rates of diagnostic error from 8% in a general PICU population to 12% among unexpected critical admissions. About a quarter of those patients were discussed at PICU morbidity and mortality conferences. Most misdiagnosed conditions were cardiovascular, infectious, congenital, or neurologic. System, cognitive, and both system and cognitive factors were associated with diagnostic error but there is limited information on the impact of misdiagnosis.
Citation: Cifra CL, Custer JW, Singh H . Diagnostic errors in pediatric critical care: a systematic review. Pediatr Crit Care Med 2021 Aug;22(8):701-12. doi: 10.1097/pcc.0000000000002735..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Intensive Care Unit (ICU), Critical Care
Patterson BW, Johnson J, Ward MD
Effect of a split-flow physician in triage model on abdominal CT ordering rate and yield.
The objective of this study was to compare the rate and clinical yield of computed tomography (CT) imaging between patients presenting with abdominal pain initially seen by a physician in triage (PIT) versus those seen only by physicians working in the main emergency department (ED). For patients with abdominal pain, the investigators found no significant differences in rates of CT ordering or CT yield for patients seen in a PIT vs. traditional models.
Citation: Patterson BW, Johnson J, Ward MD . Effect of a split-flow physician in triage model on abdominal CT ordering rate and yield. Am J Emerg Med 2021 Aug;46:160-64. doi: 10.1016/j.ajem.2020.05.119..
Keywords: Imaging, Emergency Department, Practice Patterns, Diagnostic Safety and Quality
Choi DT, Davila JA, Sansgiry S
Factors associated with delay of diagnosis of hepatocellular carcinoma in patients with cirrhosis.
Researchers examined the frequency of and factors associated with delays in diagnosis of hepatocellular carcinoma (HCC) in a cohort of patients with cirrhosis in the Veterans Health Administration (VHA). Data was collected and analyzed from VHA electronic health records. They found that nearly half of veterans with cirrhosis have delays in diagnosis of HCC of 60 days or more after a red flag, defined by guidelines. They recommended interventions to improve timely follow-up of red flags and adherence to guidelines in order to increase early detection of HCC.
Citation: Choi DT, Davila JA, Sansgiry S . Factors associated with delay of diagnosis of hepatocellular carcinoma in patients with cirrhosis. Clin Gastroenterol Hepatol 2021 Aug;19(8):1679-87. doi: 10.1016/j.cgh.2020.07.026..
Keywords: Cancer, Diagnostic Safety and Quality