Background: Despite a commitment to high-quality medical education, diagnostic errors continue to be pervasive. Clinical presentations with nonspecific symptoms and diagnoses with wide differentials are prone to diagnostic errors; dizziness may be the epitome of this conundrum. Dizziness is a common symptom, costly to assess, and frequently misdiagnosed. Diagnostic decisions have high stakes, given the […]

Background: Diagnostic error is commonly defined as a missed or delayed diagnosis and has been described as among the most important patient safety hazards. Diagnostic errors also account for the largest category of medical malpractice high severity claims and total payouts. Despite a large literature on the incidence of inpatient adverse events, no systematic review […]

Background: Diagnostic errors in hospitalized patients are difficult to identify and quantify: error rates range from 4.8 to 49.8%. Though chart review tools, like the Safer Dx instrument, have been developed to assess the presence of diagnostic error in ambulatory settings, they have yet to be validated for acute care. A key issue is identifying […]

Background: Clinicians often diagnose bacterial infections such as urinary tract infection (UTI) and pneumonia in patients who are asymptomatic or have non-bacterial causes of their symptoms. Misdiagnosis of infection leads to unnecessary antibiotic use and potentially delays correct diagnoses. Interventions to improve diagnosis often focus on infections separately. However, if misdiagnosis is linked at the […]

Case Presentation: A 66-year-old woman with hypertension presented to the hospital one day after arrival to New York City from Guinea with chronic daily vomiting, unintentional weight loss, progressive shoulder pain, and a subacute pruritic rash. She denied fevers, night sweats, difficulty breathing, chest pain, palpitations, unusual skin exposures, insect bites, trauma to the shoulder, […]

Case Presentation: An 80-year-old man with prostate cancer and radical prostatectomy with an indwelling Foley catheter presented from his nursing home with three days of hematuria and a hemoglobin of 5.2 mg/dL (baseline 7-9 mg/dL). Initial vital signs were normal. Exam was significant for pink-tinged urine, copious melena, and no abdominal pain. A repeat hemoglobin […]