Online public response to emergency department diagnostic error report: A qualitative study.

IF 3.4 3区 医学 Q1 EMERGENCY MEDICINE Academic Emergency Medicine Pub Date : 2024-11-12 DOI:10.1111/acem.15047
Timothy J Sanford, Pranav Kaul, Danielle M McCarthy
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Abstract

Background: The 2022 study on diagnostic error in the emergency department (ED) published by the Agency for Healthcare Research and Quality (AHRQ) reported that one in every 18 ED patients is misdiagnosed. The report was methodologically critiqued by emergency physicians and researchers. However, little is known about public perception of error in the ED. We sought to characterize public response to AHRQ's publication.

Methods: A search was conducted for online news articles published December 2022 reporting the AHRQ study and containing "public comment" sections. Verbatim comments and relevant characteristics were collected. Three coders completed content analysis and resolved any differences. Descriptive statistics and themes are reported.

Results: Fifteen online articles were reviewed; three had public comment sections (New York Times, DailyMail, and Boston Globe). There were 553 unique user comments; 293 were original comments (53%) and 260 were replies to comments (47%). The 260 replies were in response to 113 original comments, with the remaining original comments having 0 replies (n = 180). Of the 202 commenters who identified a personal role in a health care encounter, 70 (35%) identified as patients and 68 (34%) identified as physicians. Comments centered on seven major themes: (1) negative personal experiences, (2) reframing study conclusions, (3) sense of decline in training standards, (4) internal stressors impeding ED diagnostic accuracy, (5) external stressors impeding ED diagnostic accuracy, (6) suggested solutions, and (7) role of the ED in diagnosis.

Conclusions: The news coverage of AHRQ's report provided individuals a platform to share their perspectives. Many comments reflected a nuanced understanding of the role of emergency care and the stressors of the ED environment. Despite questions about the report's accuracy, there were many individuals who shared personal negative experiences suggesting that the public may feel directly impacted by error in the ED.

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公众对急诊科诊断错误报告的在线反应:定性研究。
背景:医疗保健研究与质量机构(AHRQ)发布的 2022 年急诊科(ED)诊断错误研究报告称,每 18 名急诊科患者中就有一人被误诊。急诊科医生和研究人员对该报告的方法进行了批评。然而,公众对急诊室误诊的看法却知之甚少。我们试图描述公众对 AHRQ 发表的报告的反应:我们搜索了 2022 年 12 月发表的报道 AHRQ 研究并包含 "公众评论 "部分的在线新闻文章。收集了逐字评论和相关特征。三位编码员完成了内容分析并解决了任何分歧。结果:共审查了 15 篇在线文章,其中三篇有公众评论部分(《纽约时报》、《每日邮报》和《波士顿环球报》)。共有 553 条独特的用户评论;其中 293 条是原始评论(占 53%),260 条是对评论的回复(占 47%)。260 条回复是对 113 条原始评论的回应,其余原始评论的回复数为 0(n = 180)。在 202 位确定了个人在医疗服务中角色的评论者中,70 位(35%)确定为患者,68 位(34%)确定为医生。评论主要围绕七个主题:(1) 消极的个人经历,(2) 研究结论的重构,(3) 培训标准下降的感觉,(4) 阻碍急诊室诊断准确性的内部压力,(5) 阻碍急诊室诊断准确性的外部压力,(6) 建议的解决方案,(7) 急诊室在诊断中的作用:AHRQ 报告的新闻报道为个人提供了一个分享观点的平台。许多评论反映了人们对急诊护理的作用和急诊室环境压力的细微理解。尽管有人质疑报告的准确性,但也有很多人分享了个人的负面经历,这表明公众可能会直接感受到急诊室错误的影响。
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来源期刊
Academic Emergency Medicine
Academic Emergency Medicine 医学-急救医学
CiteScore
7.60
自引率
6.80%
发文量
207
审稿时长
3-8 weeks
期刊介绍: Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM) and publishes information relevant to the practice, educational advancements, and investigation of emergency medicine. It is the second-largest peer-reviewed scientific journal in the specialty of emergency medicine. The goal of AEM is to advance the science, education, and clinical practice of emergency medicine, to serve as a voice for the academic emergency medicine community, and to promote SAEM''s goals and objectives. Members and non-members worldwide depend on this journal for translational medicine relevant to emergency medicine, as well as for clinical news, case studies and more. Each issue contains information relevant to the research, educational advancements, and practice in emergency medicine. Subject matter is diverse, including preclinical studies, clinical topics, health policy, and educational methods. The research of SAEM members contributes significantly to the scientific content and development of the journal.
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