Diagnostic difficulty and error in primary care--a systematic review.

Background: Diagnostic error in primary care can have serious implications for the patient, the clinician and the health-care system, possibly more so than other types of error.

Objective: To identify common characteristics of diseases that GPs may misdiagnose.

Methods: Systematic search of the MEDLINE and EMBASE databases for primary research on diagnostic error/delay in primary care.

Predictors of diagnostic accuracy and safe management in difficult diagnostic problems in family medicine.

Objective: To investigate the role of information gathering and clinical experience on the diagnosis and management of difficult diagnostic problems in family medicine.

Method: Seven diagnostic scenarios including 1 to 4 predetermined features of difficulty were constructed and presented on a computer to 84 physicians: 21 residents in family medicine, 21 family physicians with 1 to 3 y in practice, and 42 family physicians with >or=10 y in practice. Following the Active Information Search process tracing approach, participants were initially presented with a patient description and presenting complaint and were subsequently able to request further information to diagnose and manage the patient.