One of the most pressing issues in health care today is the quality and safety of care that people receive. Diagnostic errors, which include both delayed and inaccurate diagnoses, are the most common cause of medical errors reported by patients, accounting for nearly 60 percent of all errors.

The Moore Foundation’s Diagnostic Excellence Initiative team recently partnered with the editors at the Journal of the American Medical Association (JAMA), the most widely circulated general medicine journal in the world, to publish a series of Viewpoint essays written by leading thinkers and researchers in health care that explore different aspects of diagnostic excellence.

The inaugural essay in the diagnostic excellence series was written by Moore Foundation president Harvey Fineberg along with Karen Cosby and Daniel Yang, directors for the Patient Care Program. This Viewpoint kicked off the series by describing a framework for diagnostic excellence which embraces the six dimensions of health care quality enumerated by the Institute of Medicine in 2001: diagnosis must be safe, effective, patient-centered, timely, efficient, and equitable. The Viewpoint essays that followed addressed a wide range of topics related to diagnostic excellence including the historical context and evolving meaning of diagnosis to patients, the role of artificial intelligence tools to improve diagnosis, and how we might better align financial incentives and policy to improve diagnosis.

After several essays highlighting the challenges and importance of diagnostic excellence, the Viewpoint series concluded in September 2022 - Harvey Fineberg along with Susan Song and Tommy Wang, Patient Care Program team members, penned a final piece that discusses the future of diagnostic excellence. 

A full list of the Viewpoint series is below:


Diagnostic Excellence

Daniel Yang, M.D., Harvey V. Fineberg, M.D., Ph.D., Karen Cosby, M.D.

Diagnosis and the Illness Experience: Ways of Knowing

Amrapali Maitra, M.D., Ph.D., Abraham Verghese, M.D.

Diagnostic Excellence Through the Lens of Patient-Centeredness

Donald M. Berwick, M.D., M.P.P.

Next-Generation Artificial Intelligence for Diagnosis: From Predicting Diagnostic Labels to “Wayfinding”

Julia Adler-Milstein, Ph.D., Jonathan H. Chen, M.D., Ph.D., Gurpreet Dhaliwal, M.D.

Achieving Diagnostic Excellence for Sepsis

Derek C. Angus, M.D., M.P.H., Andrew B. Bindman, M.D.

The Rational Diagnostician and Achieving Diagnostic Excellence

Pat Croskerry, M.D. Ph.D.

At-home Diagnostics and Diagnostic Excellence: Devices vs. General Wellness Products

David A. Simon, J.D., L.L.M., Ph.D., Carmel Shachar, J.D., M.P.H., I. Glenn Cohen, J.D.

Achieving Diagnostic Excellence for Older Patients

Christine Cassel, M.D., Terry Fulmer, Ph.D., R.N.

Understanding and Communicating Uncertainty in Achieving Diagnostic Excellence

Maria R. Dahm, M.A., Ph.D.; Carmel Crock, M.B.B.S., BLitt

Evaluating the Effectiveness of Diagnostic Tests

Ashley Graham Kennedy, Ph.D.

Aligning Incentives for Improving Diagnostic Excellence

Bob Kocher, M.D., Ezekiel J. Emanuel, M.D., Ph.D.

Improving Efficiency in Medical Diagnosis 

Leila Agha, Ph.D.; Jonathan Skinner, Ph.D.; David Chan, M.D., Ph.D.

Measuring Performance of the Diagnostic Process 

Helen Burstin, M.D., M.P.H.; Karen Cosby, M.D.

Learning the Art and Science of Diagnosis 

Allan S. Detsky, M.D., Ph.D.

Achieving Equity in Diagnostic Excellence 

Kathryn M. McDonald, M.M., Ph.D.

Diagnostic Excellence and Patient Safety: Strategies and Opportunities 

Nirav R. Shah, M.D., MPH.; Tejal K. Gandhi, M.D., MPH; David W. Bates, M.D., M.S.

Rethinking Algorithm Performance Metrics for Artificial Intelligence in Diagnostic Medicine

Matthew A. Reyna, Ph.D., M.S.; Elaine O. Nsoesie, Ph.D.; Gari D. Clifford, DPhil, M.A., MSc

Achieving Diagnostic Excellence for Cancer: Symptom Detection as a Partner to Screening 

Elizabeth A. Sarma, Ph.D., MPH; Fiona M. Walter, M.A., M.D.; Sarah C. Kobrin, Ph.D., MPH

Decoding Artificial Intelligence to Achieve Diagnostic Excellence: Learning from Experts, Examples and Experience

Jonathan H. Chen, M.D., Ph.D.; Gurpreet Dhaliwal, M.D.; Daniel Yang, M.D. 

Achieving Diagnostic Equity in Cardiovascular Disease 

Urmimala Sarkar M.D., MPH; Kirsten Bibbins-Domingo, Ph.D., M.D., MAS

The Future of Diagnostic Excellence 

Harvey V. Fineberg, M.D., Ph.D.; Susan Song, MPH; Tommy Wang, Ph.D.


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