| Ref ID | 1028 |
| First Author | G.D. Kelen |
| Journal | ANNALS OF EMERGENCY MEDICINE |
| Year Of Publishing | 2023 |
| URL | https://www-sciencedirect-com.sheffield.idm.oclc.org/science/article/pii/S0196064423002238?via%3Dihub |
| Keywords |
• Emergency medicine • External validity • Harms |
| Problem(s) |
• Ignores setting or context of included studies which limits review applicability • Lack of clinical expert/ stakeholder/ user perspective • Review question not justified / important • Spin or subjective interpretation of findings |
| Article Type | Editorial |
| Article Subtype | Comment/letter |
| First Author Country | United States |
| Aim | To draw attention to a number of issues in a systematic review by the Agency for Healthcare Research and Quality (AHRQ) on diagnostic errors in the emergency department. |
| Level of Investigation | Descriptive |
| Summary of Findings | The authors of the letter on a systematic review by the Agency for Healthcare Research and Quality (AHRQ) published in 2022, on diagnostic errors in the emergency department point out the following methodological issues which they believe do not support the findings. The letter claims: 1) The report asked the wrong question as definitive diagnoses are not the priority for emergency practice, patients are not at high risk of diagnostic error in emergency departments, and ignores the issue of patient crowding which does present a risk to patient safety. 2) The report did not use the appropriate methodology due to not using the most accepted definition of diagnostic error, it used international studies not generalisable to the US, the authors did not respond to public comments highlighting methodological flaws, a lack of clarity if the inpatient teams perpetuated the claimed diagnostic error, and the inpatient and outpatient diagnoses used for comparisons may not be correct. 3) The report gave the wrong answer by including only 3 small international studies based on study designs that were retrospective or on chart review were considered “high quality” and “prospective.”, and attributing of the cause of ED diagnostic errors from malpractice data. |
| Number of systematic reviews included | 1 |
| Number of eligible systematic reviews assessed | 1 |
| Treatment impacted | Not Applicable |
| Treatment impacted description | |
| Interpretation impacted | Not Applicable |
| Interpretation impacted description |