diagnosis safety

You know that a healthcare topic has hit the big time when it has both a professional society to advocate for the issue and a peer-reviewed journal to foster and highlight research in the area. There is no question that the major contribution that misdiagnosis makes to the overall problem of patient safety has captured the attention of a variety of healthcare stakeholders as several of our recent publications illustrate:

So, a press release announcing a “deeper partnership between the Society to Improve Diagnosis in Medicine (SIDM) and the publisher of the peer-reviewed journal, DIAGNOSIS,” caught my eye.

 

SIDM and Diagnosis

SIDM is a nonprofit organization whose members include clinicians and other healthcare professionals, patients, and every stakeholder in the diagnostic process. It is the only organization that focuses solely on improving the quality and safety of medical diagnoses. In 2015, SIDM convened the Coalition to Improve Diagnosis to increase awareness of the issue and advocate for improvement. The coalition has 32 prominent healthcare organizations as members. Visit www.improvediagnosis.org to learn more. The organization also sponsors the annual Diagnostic Error in Medicine (DEM) conference. The next one, the society’s 10th, is being held October 8-10, 2017 in Boston, Mass.

The journal DIAGNOSIS is more recent having been launched in 2014. According to SIDM executives, the partnership with SIDM will “expand the reach of the quarterly publication in the future, and increase attention on the pervasive problem of misdiagnosis in the United States and internationally.” The journal aims to answer the question of how diagnosis determines the quality of medical care. By focusing on how diagnostic medicine can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors, the journal aspires to advance the practice of diagnostic excellence. It does this by providing “a platform to highlight both fundamental and applied research, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality.

Members of the SIDM community have been involved with the journal since its inception. SIDM founder and president, Mark L. Graber, MD, FACP, also serves as its Co-Editor-in-Chief, with Professor Mario Plebani of the University of Padua, Italy.

Dr. Graber points out that,

“Diagnosis is the foundation of medical practice, yet too often we get it wrong”

Under the partnership announced today, SIDM will work with the journal’s publisher, De Gruyter, to significantly increase the journal’s readership in the United States as well as globally, while broadening its base of contributors. In addition, the journal will now highlight SIDM activities and projects, and access will be available free of charge to SIDM contributing members. Further SIDM will increase its role in generating content that reflects cross-sectoral collaboration and diversity, and also increase promotional efforts among a wide group of audiences, including patients, clinicians, and healthcare system leaders.

 

What’s involved in making a correct diagnosis?

Dr. Graber says that “diagnosis encompasses a range of complexities that include gaining patient trust, collecting accurate medical histories, performing diagnostic tests, and synthesizing all of this information to communicate the proposed diagnosis in terms the patient can understand. The journal helps increase our understanding of these issues to improve the quality and safety of this complex diagnostic process.

According to the press release, studies show that 1 in 10 diagnoses are either incorrect or delayed. SIDM aims to ensure no patients are harmed by diagnostic error by ensuring that diagnosis is accurate, timely, efficient, and safe.

Experts agree that diagnosis is one of the most difficult and complex tasks in healthcare, with more than 10,000 potential diagnoses, thousands of testing choices, and the overriding challenge that symptoms vary considerably among individuals. The Institute of Medicine reported in 2015 that error in diagnosis, often overlooked, is a systematic issue that affects an estimated 1 in 20 primary care patients, or more than 12 million Americans each year.

 

Why diagnosis is so important

Diagnosis is foundational in medicine as everything else that happens to a patient stems from that activity. In fact, you could argue that almost all other aspects of patient safety result from the presumed or actual diagnosis of the patient. The surgical error that causes a stroke would not have happened if the correct diagnosis did not require an operation. An adverse drug reaction that lands a person in the hospital was avoidable if the correct diagnosis did not require that drug. I could go on and on, but you get the point. Getting to a correct diagnosis is THE most important thing that happens in medicine. It is high-time it is getting the attention it deserves.

Patricia Salber MD, MBA (@docweighsin)
Patricia Salber, MD, MBA is the Founder and Editor-in-Chief of The Doctor Weighs In. She is also a physician executive who has worked in all aspects of healthcare including practicing emergency physician, health plan executive, consultant to employers, CMS, and other organizations. She is a Board Certified Internist and Emergency Physician who loves to write about just about anything that has to do with healthcare.

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