Journal article
Factors Associated With Diagnostic Error on Admission to a PICU: A Pilot Study
Pediatric critical care medicine, Vol.21(5), pp.e311-E315
05/2020
DOI: 10.1097/PCC.0000000000002257
PMCID: PMC7224314
PMID: 32097247
Abstract
Diagnostic errors can harm critically ill children. However, we know little about their prevalence in PICUs and factors associated with error. The objective of this pilot study was to determine feasibility of record review to identify patient, provider, and work system factors associated with diagnostic errors during the first 12 hours after PICU admission.
Pilot retrospective cohort study with structured record review using a structured tool (Safer Dx instrument) to identify diagnostic error.
Academic tertiary referral PICU.
Patients 0-17 years old admitted nonelectively to the PICU.
None.
Four of 50 patients (8%) had diagnostic errors in the first 12 hours after admission. The Safer Dx instrument helped identify delayed diagnoses of chronic ear infection, increased intracranial pressure (two cases), and Bartonella encephalitis. We calculated that 610 PICU admissions are needed to achieve 80% power (α = 0.05) to detect significant associations with error.
Our pilot study found four patients with diagnostic error out of 50 children admitted nonelectively to a PICU. Retrospective record review using a structured tool to identify diagnostic errors is feasible in this population. Pilot data are being used to inform a larger and more definitive multicenter study.
Details
- Title: Subtitle
- Factors Associated With Diagnostic Error on Admission to a PICU: A Pilot Study
- Creators
- Christina L Cifra - Division of Pediatric Critical Care, Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IAPatrick Ten Eyck - Biostatistics Core, Institute for Clinical and Translational Science, University of Iowa, Iowa City, IAJeffrey D Dawson - Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IAHeather Schacht Reisinger - Center for Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IAHardeep Singh - Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TXLoreen A Herwaldt - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Pediatric critical care medicine, Vol.21(5), pp.e311-E315
- DOI
- 10.1097/PCC.0000000000002257
- PMID
- 32097247
- PMCID
- PMC7224314
- NLM abbreviation
- Pediatr Crit Care Med
- ISSN
- 1529-7535
- eISSN
- 1947-3893
- Grant note
- K12 HD027748 / NICHD NIH HHS UL1 TR002537 / NCATS NIH HHS R01 HS022087 / AHRQ HHS
- Language
- English
- Date published
- 05/2020
- Academic Unit
- Public Health Administration; Infectious Diseases; Stead Family Department of Pediatrics; Epidemiology; Biostatistics; Center for Social Science Innovation; Internal Medicine
- Record Identifier
- 9984214813402771
Metrics
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