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September 26, 2012

Bringing Diagnosis Into the Quality and Safety Equations

Author Affiliations

Author Affiliations: RTI International, St James, New York (Dr Graber); Department of Medicine, University of California at San Francisco (Dr Wachter); and American Board of Internal Medicine, Philadelphia, Pennsylvania (Dr Cassel).

JAMA. 2012;308(12):1211-1212. doi:10.1001/2012.jama.11913

Cases of delayed, missed, and incorrect diagnosis are common, with an incidence in the range of 10% to 20%.1 Some errors in diagnosis stem from mistakes in the interpretation of diagnostic tests. For example, pathology, radiology, and the clinical laboratory each have error rates of 2% to 5%. Superimposed on these testing errors are the ubiquitous system-related errors encountered in every health care organization, as well as cognitive errors caused by faulty clinical reasoning. Diagnostic errors do not occur only in connection with unusual conditions but span the breadth of clinical medicine, from rare disorders to commonplace ones like anemia and asthma.2,3

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