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本文引用的文献

1
Diagnostic Stewardship to Prevent Diagnostic Error.预防诊断错误的诊断管理
JAMA. 2023 Apr 18;329(15):1255-1256. doi: 10.1001/jama.2023.1678.
2
Principles of diagnostic stewardship: A practical guide from the Society for Healthcare Epidemiology of America Diagnostic Stewardship Task Force.诊断管理原则:美国医疗保健流行病学学会诊断管理工作组实用指南。
Infect Control Hosp Epidemiol. 2023 Feb;44(2):178-185. doi: 10.1017/ice.2023.5.
3
Creating a Learning Health System for Improving Diagnostic Safety: Pragmatic Insights from US Health Care Organizations.创建学习型医疗体系以提高诊断安全性:来自美国医疗机构的实用见解。
J Gen Intern Med. 2022 Nov;37(15):3965-3972. doi: 10.1007/s11606-022-07554-w. Epub 2022 Jun 1.
4
Overdiagnosis: what it is and what it isn't.过度诊断:是什么以及不是什么。
BMJ Evid Based Med. 2018 Feb;23(1):1-3. doi: 10.1136/ebmed-2017-110886.

美国疾病控制与预防中心促进卓越诊断的核心要素。

CDC's Core Elements to promote diagnostic excellence.

作者信息

Morgan Daniel J, Singh Hardeep, Srinivasan Arjun, Bradford Andrea, McDonald L Clifford, Kutty Preeta K

机构信息

Department of Epidemiology and Public Health, University of Maryland School of Medicine and VA Maryland Healthcare System, Baltimore, MD, USA.

Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, and Baylor College of Medicine, Houston, TX, USA.

出版信息

Diagnosis (Berl). 2024 Nov 28;12(2):197-200. doi: 10.1515/dx-2024-0163. eCollection 2025 May 1.

DOI:10.1515/dx-2024-0163
PMID:39602334
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12105987/
Abstract

Nearly a decade after the National Academy of Medicine released the "Improving Diagnosis in Health Care" report, diagnostic errors remain common, often leading to physical, psychological, emotional, and financial harm. Despite a robust body of research on potential solutions and next steps, the translation of these efforts to patient care has been limited. Improvement initiatives are still narrowly focused on selective themes such as diagnostic stewardship, preventing overdiagnosis, and enhancing clinical reasoning without comprehensively addressing vulnerable systems and processes surrounding diagnosis. To close this implementation gap, the US Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Diagnostic Excellence programs on September 17, 2024. This initiative aligns with the World Health Organization's (WHO) 2024 World Patient Safety Day focus on improving diagnosis. These Core Elements provide guidance for the formation of hospital programs to improve diagnosis and aim to integrate various disparate efforts in hospitals. By creating a shared mental model of diagnostic excellence, the Core Elements of Diagnostic Excellence supports actions to break down silos, guide hospitals toward multidisciplinary diagnostic excellence teams, and provide a foundation for building diagnostic excellence programs in hospitals.

摘要

在美国国家医学院发布《改善医疗保健诊断》报告近十年后,诊断错误仍然很常见,常常导致身体、心理、情感和经济伤害。尽管有大量关于潜在解决方案和后续步骤的研究,但这些努力在转化为患者护理方面却很有限。改进举措仍然狭隘地集中在诸如诊断管理、防止过度诊断以及加强临床推理等选择性主题上,而没有全面解决围绕诊断的脆弱系统和流程。为了弥合这一实施差距,美国疾病控制与预防中心(CDC)于2024年9月17日发布了医院卓越诊断项目的核心要素。该倡议与世界卫生组织(WHO)2024年世界患者安全日改善诊断的重点相一致。这些核心要素为医院改善诊断的项目形成提供指导,并旨在整合医院内各种不同的努力。通过创建卓越诊断的共享思维模式,卓越诊断核心要素支持采取行动打破壁垒,引导医院建立多学科卓越诊断团队,并为在医院建立卓越诊断项目提供基础。