title: Primary care pediatricians' interest in diagnostic error reduction.
abstract: BACKGROUND
  Diagnostic errors causing harm in children are understudied, resulting in a knowledge gap regarding pediatricians' interest in reducing their incidence.
  
  
  METHODS
  Electronic survey of general pediatricians focusing on diagnostic error incidence, errors they were interested in trying to improve, and errors reduced by their electronic health record (EHR).
  
  
  RESULTS
  Of 300 contacted pediatricians, 77 (26%) responded, 58 (19%) served ambulatory patients, and 48 (16%) completed the entire questionnaire. Of these 48, 17 (35%) reported making a diagnostic error at least monthly, and 16 (33%) reported making a diagnostic error resulting in an adverse event at least annually. Pediatricians were "most" interested in "trying to improve" missed diagnosis of hypertension (17%), delayed diagnosis due to missed subspecialty referral (15%), and errors associated with delayed follow-up of abnormal laboratory values (13%). Among the 44 pediatricians with an EHR, 16 (36%) said it reduced the likelihood of missing obesity and 14 (32%) said it reduced the likelihood of missing hypertension. Also, 15 (34%) said it helped avoid delays in follow-up of abnormal laboratory values. A third (36%) reported no help in diagnostic error reduction from their EHR.
  
  
  CONCLUSIONS
  Pediatricians self-report an appreciable number of diagnostic errors and were most interested in preventing high frequency, non-life-threatening errors. There exists a need to leverage EHRs to support error reduction efforts.
authors.affiliation: 1Department of Pediatrics, The Children's Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rinke
authors.affiliation: 2Center for Innovations in Quality, Effectiveness and Safety, Michael E. Debakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Hardeep
authors.initials: H
authors.lastname: Singh
authors.affiliation: 3Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ruberman
authors.affiliation: 4Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Adelman
authors.affiliation: 1Department of Pediatrics, The Children's Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: 1Department of Pediatrics, The Children's Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: O'Donnell
authors.affiliation: 1Department of Pediatrics, The Children's Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Ruth E K
authors.initials: REK
authors.lastname: Stein
authors.affiliation: 5Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Tammy M
authors.initials: TM
authors.lastname: Brady
authors.affiliation: 6Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Moonseong
authors.initials: M
authors.lastname: Heo
authors.affiliation: 7Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Lehmann
authors.affiliation: 8Jersey Shore University Medical Center, Neptune, NJ, USA9The American Academy of Pediatrics Division of Quality, Quality Improvement Innovation Networks, Elk Grove Village, IL, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Kairys
authors.affiliation: 9The American Academy of Pediatrics Division of Quality, Quality Improvement Innovation Networks, Elk Grove Village, IL, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rice-Conboy
authors.affiliation: 9The American Academy of Pediatrics Division of Quality, Quality Improvement Innovation Networks, Elk Grove Village, IL, USA.
authors.forename: Keri
authors.initials: K
authors.lastname: Theissen
authors.affiliation: 10Medical University of South Carolina, Charleston, SC, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Bundy
keywords: diagnostic error; pediatrics; primary care