Developing methods to identify resilience and improve communication about diagnosis in pediatric primary care.

Communication underlies every stage of the diagnostic process. The Dialog Study aims to characterize the pediatric diagnostic journey, focusing on communication as a source of resilience, in order to ultimately develop and test the efficacy of a structured patient-centered communication intervention in improving outpatient diagnostic safety. In this manuscript, we will describe protocols, data collection instruments, methods, analytic approaches, and theoretical frameworks to be used in to characterize the patient journey in the Dialog Study.

Improving communication of diagnostic uncertainty to families of hospitalized children.

Objectives: Diagnostic uncertainty is not reliably communicated to patients and caregivers. This study aims to identify barriers and facilitators to effective communication of diagnostic uncertainty, including development of potential tools and strategies for improvement, as perceived by healthcare professionals and caregivers.

Methods: We completed structured interviews with providers and caregivers of hospitalized children with uncertain diagnoses (UD).

Developing a machine learning model to detect diagnostic uncertainty in clinical documentation.

Background And Objective: Diagnostic uncertainty, when unrecognized or poorly communicated, can result in diagnostic error. However, diagnostic uncertainty is challenging to study due to a lack of validated identification methods. This study aims to identify distinct linguistic patterns associated with diagnostic uncertainty in clinical documentation.

Diagnosis Code and Health Care Utilization Patterns Associated With Diagnostic Uncertainty.

Background And Objectives: Diagnostic uncertainty is challenging to identify and study in clinical practice. This study compares differences in diagnosis code and health care utilization between a unique cohort of hospitalized children with uncertain diagnoses (UD) and matched controls.

Patients And Methods: This case-control study was conducted at Cincinnati Children's Hospital Medical Center.

Diagnostic Error in Pediatrics: A Narrative Review.

A priority topic for patient safety research is diagnostic errors. However, despite the significant growth in awareness of their unacceptably high incidence and associated harm, a relative paucity of large, high-quality studies of diagnostic error in pediatrics exists. In this narrative review, we present what is known about the incidence and epidemiology of diagnostic error in pediatrics as well as the established research methods for identifying, evaluating, and reducing diagnostic errors, including their strengths and weaknesses.

Declaring Uncertainty: Using Quality Improvement Methods to Change the Conversation of Diagnosis.

Background: Diagnostic uncertainty may be a sign that a patient's working diagnosis is incorrect, but literature on proactively identifying diagnostic uncertainty is lacking. Using quality improvement methodologies, we aimed to create a process for identifying patients with uncertain diagnoses (UDs) on a pediatric inpatient unit and communicating about them with the interdisciplinary health care team.

Methods: Plan-do-study-act cycles were focused on interdisciplinary communication, structured handoffs, and integration of diagnostic uncertainty into the electronic medical record.

Increasing Physician Reporting of Diagnostic Learning Opportunities.

Background: An estimated 10% of Americans experience a diagnostic error annually, yet little is known about pediatric diagnostic errors. Physician reporting is a promising method for identifying diagnostic errors. However, our pediatric hospital medicine (PHM) division had only 1 diagnostic-related safety report in the preceding 4 years.

Uncertain diagnoses in a children's hospital: patient characteristics and outcomes.

Background: A quality improvement initiative at our institution resulted in a new process for prospectively identifying pediatric hospital medicine (PHM) patients with uncertain diagnoses (UD). This study describes the clinical characteristics and healthcare utilization patterns of patients with UD.

Methods: This single center cross-sectional study included all PHM patients identified with UD during their admission.

Enhanced aerobic exercise performance in women by a combination of three mineral Chelates plus two conditionally essential nutrients.

Background: Certain essential and conditionally essential nutrients (CENs) perform functions involved in aerobic exercise performance. However, increased intake of such nutrient combinations has not actually been shown to improve such performance.

Methods: For 1 mo, aerobically fit, young adult women took either a combination of 3 mineral glycinate complexes (daily dose: 36 mg iron, 15 mg zinc, and 2 mg copper) + 2 CENs (daily dose: 2 g carnitine and 400 mg phosphatidylserine), or the same combination with generic mineral complexes, or placebo ( = 14/group).

Prevalence of baby bottle versus breastfeeding graphics on products in national chain stores.

Objective: This study surveyed the prevalence of bottle versus breastfeeding graphic images on products marketed for pregnant mothers and young children available for purchase in national chain stores.

Study Design And Methods: This was a product survey/content analysis. Eighteen national chain stores located in a 10-mile radius of Charlottesville, VA were visited.