PDF(Pubmed)
Abstract：
To apply a human factors framework to understand whether checklists reduce clinical diagnostic error have (1) gaps in composition; and (2) components that may be more likely to reduce errors.
Systematic review.
PubMed, EMBASE, Scopus and Web of Science were searched through 15 February 2022.
Any article that included a clinical checklist aimed at improving the diagnostic process. Checklists were defined as any structured guide intended to elicit additional thinking regarding diagnosis.
Two authors independently reviewed and selected articles based on eligibility criteria. Each extracted unique checklist was independently characterised according to the well-established human factors framework: Systems Engineering Initiative for Patient Safety 2.0 (SEIPS 2.0). If reported, checklist efficacy in reducing diagnostic error (eg, diagnostic accuracy, number of errors or any patient-related outcomes) was outlined. Risk of study bias was independently evaluated using standardised quality assessment tools in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
A total of 30 articles containing 25 unique checklists were included. Checklists were characterised within the SEIPS 2.0 framework as follows: Work Systems subcomponents of Tasks (n=13), Persons (n=2) and Internal Environment (n=3); Processes subcomponents of Cognitive (n=20) and Social and Behavioural (n=2); and Outcomes subcomponents of Professional (n=2). Other subcomponents, such as External Environment or Patient outcomes, were not addressed. Fourteen checklists examined effect on diagnostic outcomes: seven demonstrated improvement, six were without improvement and one demonstrated mixed results. Importantly, Tasks-oriented studies more often demonstrated error reduction (n=5/7) than those addressing the Cognitive process (n=4/10).
Most diagnostic checklists incorporated few human factors components. Checklists addressing the SEIPS 2.0 Tasks subcomponent were more often associated with a reduction in diagnostic errors. Studies examining less explored subcomponents and emphasis on Tasks, rather than the Cognitive subcomponents, may be warranted to prevent diagnostic errors.
Systematic review.
PubMed, EMBASE, Scopus and Web of Science were searched through 15 February 2022.
Any article that included a clinical checklist aimed at improving the diagnostic process. Checklists were defined as any structured guide intended to elicit additional thinking regarding diagnosis.
Two authors independently reviewed and selected articles based on eligibility criteria. Each extracted unique checklist was independently characterised according to the well-established human factors framework: Systems Engineering Initiative for Patient Safety 2.0 (SEIPS 2.0). If reported, checklist efficacy in reducing diagnostic error (eg, diagnostic accuracy, number of errors or any patient-related outcomes) was outlined. Risk of study bias was independently evaluated using standardised quality assessment tools in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
A total of 30 articles containing 25 unique checklists were included. Checklists were characterised within the SEIPS 2.0 framework as follows: Work Systems subcomponents of Tasks (n=13), Persons (n=2) and Internal Environment (n=3); Processes subcomponents of Cognitive (n=20) and Social and Behavioural (n=2); and Outcomes subcomponents of Professional (n=2). Other subcomponents, such as External Environment or Patient outcomes, were not addressed. Fourteen checklists examined effect on diagnostic outcomes: seven demonstrated improvement, six were without improvement and one demonstrated mixed results. Importantly, Tasks-oriented studies more often demonstrated error reduction (n=5/7) than those addressing the Cognitive process (n=4/10).
Most diagnostic checklists incorporated few human factors components. Checklists addressing the SEIPS 2.0 Tasks subcomponent were more often associated with a reduction in diagnostic errors. Studies examining less explored subcomponents and emphasis on Tasks, rather than the Cognitive subcomponents, may be warranted to prevent diagnostic errors.
摘要：
应用人为因素框架以了解清单是否减少临床诊断错误具有（1）组成上的差距；（2）可能更有可能减少错误的组件。
系统评价。
PubMed,EMBASE,Scopus和WebofScience在2022年2月15日进行了搜索。
任何包含旨在改善诊断过程的临床检查表的文章。清单被定义为旨在引起有关诊断的其他思考的任何结构化指南。
两位作者根据资格标准独立审查和选择文章。根据完善的人为因素框架：患者安全系统工程计划2.0（SEIPS2.0），对每个提取的唯一清单进行独立表征。如果报告，清单在减少诊断错误方面的功效(例如，诊断准确性,错误数量或任何患者相关结局)概述。根据系统评价和荟萃分析的首选报告项目，使用标准化质量评估工具独立评估研究偏倚的风险。
共包括30篇文章，其中包含25个独特的清单。检查清单在SEIPS2.0框架内的特征如下：任务的工作系统子组件(n=13)，人员（n=2）和内部环境（n=3）；认知（n=20）和社会和行为（n=2）的过程子组件；以及专业（n=2）的结果子组件。其他子组件,如外部环境或患者结果，没有解决。十四个清单检查了对诊断结果的影响：七个证明了改善，6例没有改善,1例结果好坏参半.重要的是,与解决认知过程的研究（n=4/10）相比，以任务为导向的研究更经常证明错误减少（n=5/7）。
大多数诊断检查表包含很少的人为因素。解决SEIPS2.0任务子组件的清单通常与诊断错误的减少有关。研究检查较少探索的子组件并强调任务，而不是认知子组件，可以保证防止诊断错误。
系统评价。
PubMed,EMBASE,Scopus和WebofScience在2022年2月15日进行了搜索。
任何包含旨在改善诊断过程的临床检查表的文章。清单被定义为旨在引起有关诊断的其他思考的任何结构化指南。
两位作者根据资格标准独立审查和选择文章。根据完善的人为因素框架：患者安全系统工程计划2.0（SEIPS2.0），对每个提取的唯一清单进行独立表征。如果报告，清单在减少诊断错误方面的功效(例如，诊断准确性,错误数量或任何患者相关结局)概述。根据系统评价和荟萃分析的首选报告项目，使用标准化质量评估工具独立评估研究偏倚的风险。
共包括30篇文章，其中包含25个独特的清单。检查清单在SEIPS2.0框架内的特征如下：任务的工作系统子组件(n=13)，人员（n=2）和内部环境（n=3）；认知（n=20）和社会和行为（n=2）的过程子组件；以及专业（n=2）的结果子组件。其他子组件,如外部环境或患者结果，没有解决。十四个清单检查了对诊断结果的影响：七个证明了改善，6例没有改善,1例结果好坏参半.重要的是,与解决认知过程的研究（n=4/10）相比，以任务为导向的研究更经常证明错误减少（n=5/7）。
大多数诊断检查表包含很少的人为因素。解决SEIPS2.0任务子组件的清单通常与诊断错误的减少有关。研究检查较少探索的子组件并强调任务，而不是认知子组件，可以保证防止诊断错误。
