Priorities for improving paediatric diagnosis: findings from a modified Delphi study
Year: 2026
Type: article
Abstract: BACKGROUND: Efforts to improve diagnosis should reflect the unique needs of children; however, there is no consensus on paediatric-specific priority areas. METHODS: An expert panel of 25 United States (US) paediatric diagnostic excellence researchers, patient safety leaders and family partners from 15 institutions participated in a modified Delphi panel. Panellists participated in generating a literature-derived list of topics relevant to improving diagnosis. Panellists then rated agreement on each topic as a research or operational improvement priority. Topics that achieved consensus (≥75% of panellists rating them as high priority) were subsequently rated based on feasibility for implementation at the respondent's institution. RESULTS: Literature review identified 24 topics relevant to paediatric diagnostic safety and quality, which were expanded to 62 topics during the initial panel discussion and grouped into 25 survey topics. Consensus was reached on 6 topics as research priorities and 11 as operational improvement priorities. Of these, three were deemed highly feasible for research and three for operational improvement. Research priorities included: identifying paediatric conditions at high risk for diagnostic error, developing communication methods to enhance the diagnostic process and establishing diagnostic process feedback mechanisms. Operational improvement priorities included: identifying care delivery or health services scenarios at high risk for diagnostic error, establishing interdisciplinary, structured review of cases of diagnostic error and encouraging reporting of missed opportunities for improving diagnostic safety. CONCLUSION: Experts successfully prioritised important and feasible topics in research and practice for improving paediatric diagnosis in US academic medical centres.
Source: BMJ Quality & Safety
Authors: Irit R Rasooly, Katherine Wu, Meghan Galligan, Morgan Congdon, Anna Costello, Yasaman Fatemi, Courtney Gidengil, Joseph A Grubenhoff, Harry Hoar, Cara T Jefferies, Amarpreet Kaur, Jillian Krause, Prashant Mahajan, Sanjiv D Mehta, Jonathan G Sawicki, Trisha Marshall, Kenneth A Michelson, Ursula Nawab, Andrew P J Olson, Michael Perry, Grant Joseph Dat Chiu Shafer, Kathy N Shaw, Hardeep Singh, Kathleen Walsh, Christina L Cifra
Institutions: Children's Hospital of Philadelphia, University of Pennsylvania, Seattle Children's Hospital, University of Washington, Boston Children's Hospital, RAND Corporation, Children's Hospital Colorado, University of Colorado Anschutz, Baystate Medical Center, Baystate Health, University of Michigan, Primary Children's Hospital, University of Utah, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Lurie Children's Hospital, Johns Hopkins All Children's Hospital, University of Minnesota, Nationwide Children's Hospital, Children's Hospital of Orange County, University of California, Irvine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Harvard University
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7166156338