{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T12:47:02Z","timestamp":1794574022804,"version":"4.9.1"},"reference-count":33,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Emerg Med J"],"accepted":{"date-parts":[[2015,9,5]]},"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Diagnostic errors in the emergency department (ED) are harmful and costly. We reviewed a selected high-risk cohort of patients presenting to the ED with abdominal pain to evaluate for possible diagnostic errors and associated process breakdowns.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>We conducted a retrospective chart review of ED patients &gt;18\u2005years at an urban academic hospital. A computerised \u2018trigger\u2019 algorithm identified patients possibly at high risk for diagnostic errors to facilitate selective record reviews. The trigger determined patients to be at high risk because they: (1) presented to the ED with abdominal pain, and were discharged home and (2) had a return ED visit within 10\u2005days that led to a hospitalisation. Diagnostic errors were defined as missed opportunities to make a correct or timely diagnosis based on the evidence available during the first ED visit, regardless of patient harm, and included errors that involved both ED and non-ED providers. Errors were determined by two independent record reviewers followed by team consensus in cases of disagreement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Diagnostic errors occurred in 35 of 100 high-risk cases. Over two-thirds had breakdowns involving the patient\u2013provider encounter (most commonly history-taking or ordering additional tests) and\/or follow-up and tracking of diagnostic information (most commonly follow-up of abnormal test results). The most frequently missed diagnoses were gallbladder pathology (n=10) and urinary infections (n=5).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Diagnostic process breakdowns in ED patients with abdominal pain most commonly involved history-taking, ordering insufficient tests in the patient\u2013provider encounter and problems with follow-up of abnormal test results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/emermed-2015-204754","type":"journal-article","created":{"date-parts":[[2015,11,3]],"date-time":"2015-11-03T22:23:52Z","timestamp":1446589432000},"page":"253-259","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":74,"title":["Diagnostic errors related to acute abdominal pain in the emergency department"],"prefix":"10.1136","volume":"33","author":[{"given":"Laura","family":"Medford-Davis","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Robert Wood Johnson Foundation Clinical Scholars, University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Park","sequence":"additional","affiliation":[{"name":"Section of Emergency Medicine, Baylor College of Medicine and Harris Health System, Ben Taub General Hospital Emergency Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Shlamovitz","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Southern California Keck School of Medicine, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Suliburk","sequence":"additional","affiliation":[{"name":"Michael E DeBakey Department of Surgery, Baylor College of Medicine and Harris Health System, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley ND","family":"Meyer","sequence":"additional","affiliation":[{"name":"Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hardeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. 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