Optimizing measurement of misdiagnosis-related harms using symptom-disease pair analysis of diagnostic error (SPADE): comparison groups to maximize SPADE validity

被引:7
作者
Liberman, Ava L. [1 ,2 ]
Wang, Zheyu [3 ,4 ]
Zhu, Yuxin [3 ,5 ,6 ]
Hassoon, Ahmed [4 ]
Choi, Justin [7 ]
Austin, J. Matthew [6 ,8 ]
Johansen, Michelle C. [5 ,6 ]
Newman-Toker, David E. [5 ,6 ,9 ]
机构
[1] Weill Cornell Med, Feil Family Brain & Mind Res Inst, Clin & Translat Neurosci Unit, 420 East 70th St, New York, NY 10021 USA
[2] Weill Cornell Med, Dept Neurol, 420 East 70th St, New York, NY 10021 USA
[3] Johns Hopkins Univ, Sidney Kimmel Comprehens Canc Ctr, Div Biostat & Bioinformat, Sch Med, Baltimore, MD USA
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biostat, Baltimore, MD USA
[5] Johns Hopkins Univ, Dept Neurol, Sch Med, Baltimore, MD USA
[6] Johns Hopkins Univ, Armstrong Inst Ctr Diagnost Excellence, Sch Med, Baltimore, MD USA
[7] Weill Cornell Med, Dept Internal Med, Baltimore, MD USA
[8] Johns Hopkins Univ, Dept Anesthesia & Crit Care Med, Sch Med, Baltimore, MD USA
[9] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol & Hlth Policy & Management, Baltimore, MD USA
基金
美国国家卫生研究院;
关键词
delayed diagnosis; diagnostic errors; missed diagnosis; outcome assessment; health care; quality improvement; stroke; EMERGENCY-DEPARTMENT PATIENTS; CROSS-SECTIONAL ANALYSIS; COMPUTED-TOMOGRAPHY; VASCULAR EVENTS; DIZZINESS; STROKE; RISK; PITFALLS; VERTIGO; VISITS;
D O I
10.1515/dx-2022-0130
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Diagnostic errors in medicine represent a significant public health problem but continue to be challenging to measure accurately, reliably, and efficiently. The recently developed Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) approach measures misdiagnosis related harms using electronic health records or administrative claims data. The approach is clinically valid, methodologically sound, statistically robust, and operationally viable without the requirement for manual chart review. This paper clarifies aspects of the SPADE analysis to assure that researchers apply this method to yield valid results with a particular emphasis on defining appropriate comparator groups and analytical strategies for balancing differences between these groups. We discuss four distinct types of comparators (intra-group and inter-group for both look-back and look-forward analyses), detailing the rationale for choosing one over the other and inferences that can be drawn from these comparative analyses. Our aim is that these additional analytical practices will improve the validity of SPADE and related approaches to quantify diagnostic error in medicine.
引用
收藏
页码:225 / 234
页数:10
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