Harm of Diagnostic Errors in Hospitalized Adults

Background: Diagnostic errors may contribute to patient harm, but their frequency is unknown. Objective: To determine the prevalence, underlying cause, and harms of diagnostic errors among inpatient adults who died in the hospital or were transferred to an ICU. Design: Retrospective cohort study at 29 academic U.S. medical centers in 2019. Methods: The authors included the records of a random sample of 2428 adults hospitalized with general medical diagnoses who were transferred to the ICU and/or died in the hospital after their second hospital day. Patients admitted after an out-of-hospital cardiac arrest, on comfort care, or transferred to an ICU for a policy reason (eg, medication could only be given in an ICU) were excluded. Two physicians trained in error adjudication reviewed the entire electronic medical record for each patient and determined if a diagnostic error existed. The 2 reviewers needed to agree completely. If agreement could not be reached, a third reviewer resolved d more...