Abstract
BackgroundDiagnostic errors are a major source of preventable harm but the science of reducing them remains underdeveloped.ObjectiveTo identify and prioritize research questions to advance the field of diagnostic safety in the next 5 years.ParticipantsNinety-seven researchers and 42 stakeholders were involved in the identification of the research priorities.DesignWe used systematic prioritization methods based on the Child Health and Nutrition Research Initiative (CHNRI) methodology. We first invited a large international group of expert researchers in various disciplines to submit research questions while considering five prioritization criteria: (1) usefulness, (2) answerability, (3) effectiveness, (4) potential for translation, and (5) maximal potential for effect on diagnostic safety. After consolidation, these questions were prioritized at an in-person expert meeting in April 2019. Top-ranked questions were subsequently reprioritized through scoring on the five prioritization criteria using an online questionnaire. We also invited non-research stakeholders to assign weights to the five criteria and then used these weights to adjust the final prioritization score for each question.Key ResultsOf the 207 invited researchers, 97 researchers responded and 78 submitted 333 research questions which were then consolidated. Expert meeting participants (n = 21) discussed questions in different breakout sessions and prioritized 50, which were subsequently reduced to the top 20 using the online questionnaire. The top 20 questions addressed mostly system factors (e.g., implementation and evaluation of information technologies), teamwork factors (e.g., role of nurses and other health professionals in the diagnostic process), and strategies to engage patients in the diagnostic process.ConclusionsTop research priorities for advancing diagnostic safety in the short-term include strengthening systems and teams and engaging patients to support diagnosis. High-priority areas identified using these systematic methods can inform an actionable research agenda for reducing preventable diagnostic harm.
Highlights
High-quality research is essential to accelerate quality and safety of healthcare.[1]
The NASEM report included a list of potential research areas but prioritization of research areas and development of a specific set of actionable research questions to create impact on practice and patient care was considered outside the scope of the report
Diagnostic safety was defined as the prevention of errors and adverse effects to patients associated with the diagnostic process
Summary
High-quality research is essential to accelerate quality and safety of healthcare.[1]. Efforts are needed to inform a deeper understanding of how to reduce missed opportunities in diagnosis and achieve correct and timely diagnosis while maximizing patient experiences These efforts include identifying the main failure points given that diagnosis evolves over time within a complex sociotechnical health system,[16, 17] and developing, Zwaan et al.: Research Priorities for Diagnostic Safety Research. We first invited a large international group of expert researchers in various disciplines to submit research questions while considering five prioritization criteria: (1) usefulness, (2) answerability, (3) effectiveness, (4) potential for translation, and (5) maximal potential for effect on diagnostic safety. High-priority areas identified using these systematic methods can inform an actionable research agenda for reducing preventable diagnostic harm
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