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[Diagnostic errors are prevalent and hard to measure].

Diagnostic errors are prevalent and hard to measure Diagnostic errors are prevalent in all aspects of healthcare and a common cause of adverse events. They are often the result of multifactorial events, where there is a complex interplay between cognitive factors, system factors and lack of adequate knowledge. The generic, iterative diagnostic process, with abductive, deductive and inductive components supported by tests and the physical exam, leads to a correct diagnosis for the great majority of patients, but can be derailed by suboptimal thinking, lack of adequate information and external factors such as stress and work overload. The cognitive sciences have much to teach us about dual process theory and cognitive biases. Education, systematic feedback, lifelong learning, multidisciplinary diagnostic teams and integrated decision support are possible remedies. It is imperative that validated methods of measuring diagnostic errors and common terminologies are developed. When a diagnostic error is identified, robust routines are essential to minimise patient harm.