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Diagnostic Errors in Obstetric Morbidity and Mortality: Methods for and Challenges in Seeking Diagnostic Excellence
by
Nicole M. Krenitsky
Nicole M. Krenitsky ,
India Perez-Urbano
India Perez-Urbano and
Dena Goffman
Dena Goffman *
Department of Obstetrics and Gynecology, Vagelos College of Physicians, Columbia University, New York, NY 10023, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(14), 4245; https://doi.org/10.3390/jcm13144245 (registering DOI)
Submission received: 26 June 2024
/
Revised: 14 July 2024
/
Accepted: 16 July 2024
/
Published: 20 July 2024
Abstract
Pregnancy-related morbidity and mortality remain high across the United States, with the majority of deaths being deemed preventable. Misdiagnosis and delay in diagnosis are thought to be significant contributors to preventable harm. These diagnostic errors in obstetrics are understudied. Presented here are five selected research methods to ascertain the rates of and harm associated with diagnostic errors and the pros and cons of each. These methodologies include clinicopathologic autopsy studies, retrospective chart reviews based on clinical criteria, obstetric simulations, pregnancy-related harm case reviews, and malpractice and administrative claim database research. We then present a framework for a future study of diagnostic errors and the pursuit of diagnostic excellence in obstetrics: (1) defining and capturing diagnostic errors, (2) targeting bias in diagnostic processes, (3) implementing and monitoring safety bundles, (4) leveraging electronic health record triggers for case reviews, (5) improving diagnostic skills via simulation training, and (6) publishing error rates and reduction strategies. Evaluation of the effectiveness of this framework to ascertain diagnostic error rates, as well as its impact on patient outcomes, is required.
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MDPI and ACS Style
Krenitsky, N.M.; Perez-Urbano, I.; Goffman, D.
Diagnostic Errors in Obstetric Morbidity and Mortality: Methods for and Challenges in Seeking Diagnostic Excellence. J. Clin. Med. 2024, 13, 4245.
https://doi.org/10.3390/jcm13144245
AMA Style
Krenitsky NM, Perez-Urbano I, Goffman D.
Diagnostic Errors in Obstetric Morbidity and Mortality: Methods for and Challenges in Seeking Diagnostic Excellence. Journal of Clinical Medicine. 2024; 13(14):4245.
https://doi.org/10.3390/jcm13144245
Chicago/Turabian Style
Krenitsky, Nicole M., India Perez-Urbano, and Dena Goffman.
2024. "Diagnostic Errors in Obstetric Morbidity and Mortality: Methods for and Challenges in Seeking Diagnostic Excellence" Journal of Clinical Medicine 13, no. 14: 4245.
https://doi.org/10.3390/jcm13144245
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