诊断挑战和患者安全:准确性的关键作用-系统回顾。

IF 2.4 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Multidisciplinary Healthcare Pub Date : 2025-05-30 eCollection Date: 2025-01-01 DOI:10.2147/JMDH.S512254
Talal Ali F Alharbi, Mohammad Rababa, Hamad Alsuwayl, Abdulmajeed Alsubail, Waleed Sulaiman Alenizi
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引用次数: 0

摘要

背景:准确的诊断对患者安全、指导治疗和预防危害至关重要。诊断错误仍然普遍存在,造成了可避免的伤害,增加了医疗保健成本和发病率。了解诊断的准确性对改善临床结果至关重要。目的:本综述旨在系统探讨准确诊断对患者安全的影响,确定当前诊断实践中的挑战和改进策略。方法:2010-2024年对PubMed、CINAHL、Cochrane Library和谷歌Scholar进行综合检索。初步筛选产生了579条记录,使用了“准确诊断”、“诊断错误”和“患者安全”等关键词。在消除重复并筛选标题和摘要的相关性后,对125项研究进行了全文审查。排除标准排除了数据不足、非英文出版物和评论文章的研究,而纳入标准要求研究集中于急性护理环境中的患者安全和诊断准确性。最终,26项研究被发现符合最终资格要求,并被添加到审查中。研究设计包括回顾性队列研究和随机对照试验。结果:准确的诊断提高了治疗效果,提高了患者的安全性,减少了不必要的手术。挑战包括认知偏见、诊断工具不足和支离破碎的护理。包括人工智能(AI)和机器学习在内的技术进步大大提高了诊断精度。尽管有这些好处,临床技能的可变性和系统性障碍仍然是实质性的障碍。结论:准确诊断对提高患者安全至关重要。本综述的结果表明,使用人工智能工具、改进临床医生培训和创建标准化诊断程序可能有助于减少诊断错误;然而,由于数据量小且缺乏荟萃分析,研究结果应谨慎解读。为了进一步评估诊断准确性对患者安全的影响,未来的研究应侧重于进行更大规模的研究和统计验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic Challenges and Patient Safety: The Critical Role of Accuracy - A Systematic Review.

Background: Accurate diagnosis is critical for patient safety, guiding treatment and preventing harm. Diagnostic errors remain prevalent, contributing to avoidable harm, increased healthcare costs, and morbidity. Understanding diagnostic accuracy is essential to improving clinical outcomes.

Objective: This review aims to systematically explore the impact of accurate diagnosis on patient safety, identifying challenges in current diagnostic practices and strategies for improvement.

Methods: A comprehensive search of PubMed, CINAHL, the Cochrane Library, and Google Scholar was conducted from 2010-2024. Initial screening yielded 579 records, using keywords like "accurate diagnosis", "diagnostic errors", and "patient safety." A full-text review of 125 studies was conducted after duplicates were eliminated and titles and abstracts were screened for relevancy. Exclusion criteria excluded studies with inadequate data, non-English publications, and opinion pieces, while inclusion criteria mandated that studies concentrate on patient safety and diagnostic accuracy in acute care settings. Ultimately, 26 studies were found to meet the final eligibility requirements and were added to the review. Retrospective cohort studies and randomized controlled trials were among the study designs.

Results: Accurate diagnosis was found to improve treatment efficacy, enhances patient safety, and reduces unnecessary procedures. Challenges include cognitive biases, insufficient diagnostic tools, and fragmented care. Technological advancements, including artificial intelligence (AI) and machine learning, were found to significantly enhance diagnostic precision. Despite these benefits, variability in clinical skills and systemic barriers remain substantial obstacles.

Conclusion: Accurate diagnosis is essential to enhancing patient safety. The results of this review indicate that using AI tools, improving clinician training, and creating standardized diagnostic procedures may help reduce diagnostic errors; however, because of the small dataset and lack of meta-analysis, the findings should be interpreted cautiously. To further evaluate the effect of diagnostic accuracy on patient safety, future research should concentrate on carrying out larger-scale studies and statistical validations.

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来源期刊
Journal of Multidisciplinary Healthcare
Journal of Multidisciplinary Healthcare Nursing-General Nursing
CiteScore
4.60
自引率
3.00%
发文量
287
审稿时长
16 weeks
期刊介绍: The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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