JAMA Internal Medicine Study Highlights

A medical records review by Hardeep Singh, M.D., M.P.H., of the Michael E. DeBakey Veterans Affairs Medical Center, Houston, and colleagues, suggests that diagnostic errors in primary care settings identified in their study involved a large variety of common diseases and had significant potential for harm.

Researchers reviewed medical records of diagnostic errors through electronic health record-based triggers at a large urban Veterans Affairs facility and a large integrated private health care system. The authors focused on 190 unique instances of diagnostic errors detected in primary care visits between October 2006 and September 2007.

Most missed diagnoses were common conditions with pneumonia (6.7 percent) , decompensated congestive heart failure (5.7 percent), acute renal failure (5.3 percent), cancer (primary) (5.3 percent) and urinary tract infection or pyelonephritis (kidney infection) (4.8 percent) were the most common, according to the study results.

"Diagnostic errors are an understudied aspect of ambulatory patient safety," the study concludes.