TABLE 5

Respondents' Ranking of Most-Common Contributory Factors for Diagnostic Errors in Pediatrics

Total (N = 727)Trainee (N = 291)Academic Pediatrician (N = 289)Community Pediatrician (N = 165)
n (%)Average Rankingn (%)Average Rankingn (%)Average Rankingn (%)Average Ranking
Types of factors involved
    System-related errors, organizational issues, or problems in communication573 (79)1.78240 (82)1.91213 (79)1.76120 (73)1.59
    Interplay of cognitive and system-related factors562 (77)1.58219 (75)1.58219 (81)1.69124 (75)1.39
    Cognitive errors (inadequate data-gathering or faulty medical decision-making)524 (72)1.29205 (70)1.20195 (72)1.25124 (75)1.51
    “No-fault” errors (involving rare diseases or related to patient/caregiver nonadherence)321 (44)0.80125 (43)0.73105 (39)0.7091 (55)1.07
Types of system-related factors involved
    Inadequate care coordination, teamwork, and/or communication across clinical sites/providers596 (82)2.17237 (81)2.19225 (83)2.23134 (81)2.02
    Personnel issues (staffing or training/orientation)339 (47)0.87141 (48)0.85129 (48)0.9069 (42)0.86
    Unavailability of resources (diagnostic testing) for financial/insurance reasons219 (30)0.5194 (32)0.5868 (25)0.3957 (35)0.56
    Inadequate information systems206 (28)0.4977 (26)0.4690 (33)0.5739 (24)0.41
Types of cognitive factors involved
    Inadequate data-gathering or work-up568 (78)1.70214 (74)1.50218 (80)1.78136 (82)1.92
    Inadequate data assessment567 (78)1.63228 (78)1.71205 (76)1.57134 (81)1.59
    Inadequate recognition of critical information previously documented in chart479 (66)1.22180 (62)1.15189 (70)1.27110 (67)1.26
    Inadequate knowledge base312 (43)0.74140 (48)0.87102 (38)0.6470 (42)0.68
Types of miscellaneous factors involved
    Time/workload issues457 (63)1.50180 (62)1.51169 (62)1.44108 (65)1.61
    Inexperience of provider348 (48)0.99136 (47)0.92136 (50)1.0676 (46)0.98
    Language barriers289 (40)0.81119 (41)0.85115 (42)0.8655 (33)0.65
    Health literacy of patient/family243 (33)0.6186 (30)0.5591 (34)0.6066 (40)0.73
  • The Friedman test showed significant differences among the ranked options (P < .0001).