Editing Medical error (section)

===Definitions of diagnostic error===
Defining diagnostic error is important for measuring its frequency, identifying its causes, and implementing strategies to reduce harm and these steps that are essential for improving patient safety.<ref>{{Cite book |url=https://nap.nationalacademies.org/catalog/21794/improving-diagnosis-in-health-care |title=Improving Diagnosis in Health Care |date=2015-12-29 |publisher=National Academies Press |others=Committee on Diagnostic Error in Health Care, Board on Health Care Services, Institute of Medicine, The National Academies of Sciences, Engineering, and Medicine |isbn=978-0-309-37769-0 |editor-last=Balogh |editor-first=Erin P. |location=Washington, D.C. |editor-last2=Miller |editor-first2=Bryan T. |editor-last3=Ball |editor-first3=John R.}}</ref> The complexity of diagnosis as both a process and an outcome has led to multiple, overlapping definitions and there is no single definition of diagnostic error. One challenge is reflected in part the dual nature of the word diagnosis, which is both a noun (the name of the assigned disease; diagnosis is a label) and a verb (the act of arriving at a diagnosis; diagnosis is a process).{{Citation needed|date=April 2025}}  At the present time, there are at least 4 definitions of diagnostic error in active use:

Diagnostic error has been defined as a diagnosis that is wrong, egregiously delayed, or missed altogether.<ref name="j850">{{cite journal | last1=Graber | first1=Mark L. | last2=Franklin | first2=Nancy | last3=Gordon | first3=Ruthanna | title=Diagnostic error in internal medicine | journal=Archives of Internal Medicine | volume=165 | issue=13 | date=2005-07-11 | issn=0003-9926 | pmid=16009864 | doi=10.1001/archinte.165.13.1493 | pages=1493–1499}}</ref>  This is a "label" definition, and can only be applied in retrospect, using some gold standard (for example, autopsy findings or a definitive laboratory test) to confirm the correct diagnosis.<ref name="j850" /> Many diagnostic errors fit several of these criteria; the categories overlap.

Diagnostic error has also be defined using process-related definitions: Schiff et al. defined diagnostic error as any breakdown in the diagnostic process, including both errors of omission and errors of commission.<ref name="x375">{{cite journal | last1=Schiff | first1=Gordon D. | last2=Hasan | first2=Omar | last3=Kim | first3=Seijeoung | last4=Abrams | first4=Richard | last5=Cosby | first5=Karen | last6=Lambert | first6=Bruce L. | last7=Elstein | first7=Arthur S. | last8=Hasler | first8=Scott | last9=Kabongo | first9=Martin L. | last10=Krosnjar | first10=Nela | last11=Odwazny | first11=Richard | last12=Wisniewski | first12=Mary F. | last13=McNutt | first13=Robert A. | title=Diagnostic error in medicine: analysis of 583 physician-reported errors | journal=Archives of Internal Medicine | volume=169 | issue=20 | date=2009-11-09 | issn=1538-3679 | pmid=19901140 | doi=10.1001/archinternmed.2009.333 | pages=1881–1887}}</ref> Similarly, Singh et al. defined diagnostic error as a "missed opportunity" in the diagnostic process, based on retrospective review.<ref name="a258">{{cite journal | last=Singh | first=Hardeep | title=Editorial: Helping health care organizations to define diagnostic errors as missed opportunities in diagnosis | journal=Joint Commission Journal on Quality and Patient Safety | volume=40 | issue=3 |year=2014 | issn=1553-7250 | pmid=24730204 | doi=10.1016/s1553-7250(14)40012-6 | pages=99–101}}</ref>

In its landmark report, Improving Diagnosis in Health Care, The National Academy of Medicine proposed a new, hybrid definition that includes both label- and process-related aspects: "A diagnostic error is failure to establish an accurate and timely explanation of the patient's health problem(s) or to communicate that explanation to the patient."<ref name="s344">{{cite book | title=Improving Diagnosis in Health Care | publisher=National Academies Press | publication-place=Washington, D.C. | date=2015-12-29 | isbn=978-0-309-37769-0 | doi=10.17226/21794 | page= | pmid=26803862 | editor-last1=Balogh | editor-last2=Miller | editor-last3=Ball | editor-first1=Erin P. | editor-first2=Bryan T. | editor-first3=John R. | last1=Balogh | first1=E. P. | last2=Miller | first2=B. T. | last3=Ball | first3=J. R. | author4=Committee on Diagnostic Error in Health Care | author5=Board on Health Care Services | author6=Institute of Medicine | author7=The National Academies of Sciences, Engineering, and Medicine }}</ref> This is the only definition that specifically includes the patient in the definition wording.