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. 2025 Mar;32(3):300-308.
doi: 10.1111/acem.15047. Epub 2024 Nov 12.

Online public response to emergency department diagnostic error report: A qualitative study

Timothy J Sanford  1 , Pranav Kaul  1 , Danielle M McCarthy  1
Affiliations

Online public response to emergency department diagnostic error report: A qualitative study

Timothy J Sanford et al. Acad Emerg Med. 2025 Mar.

Abstract

Background: The 2022 study on diagnostic error in the emergency department (ED) published by the Agency for Healthcare Research and Quality (AHRQ) reported that one in every 18 ED patients is misdiagnosed. The report was methodologically critiqued by emergency physicians and researchers. However, little is known about public perception of error in the ED. We sought to characterize public response to the publication.

Methods: A search was conducted for online news articles published December 2022 reporting the diagnostic error study and containing "public comment" sections. Verbatim comments and relevant characteristics were collected. Three coders completed content analysis and resolved any differences. Descriptive statistics and themes are reported.

Results: Fifteen online articles were reviewed; three had public comment sections (New York Times, DailyMail, and Boston Globe). There were 553 unique user comments; 293 were original comments (53%) and 260 were replies to comments (47%). The 260 replies were in response to 113 original comments, with the remaining original comments having 0 replies (n = 180). Of the 202 commenters who identified a personal role in a health care encounter, 70 (35%) identified as patients and 68 (34%) identified as physicians. Comments centered on seven major themes: (1) negative personal experiences, (2) reframing study conclusions, (3) sense of decline in training standards, (4) internal stressors impeding ED diagnostic accuracy, (5) external stressors impeding ED diagnostic accuracy, (6) suggested solutions, and (7) role of the ED in diagnosis.

Conclusions: The news coverage of the diagnostic error study provided individuals a platform to share their perspectives. Many comments reflected a nuanced understanding of the role of emergency care and the stressors of the ED environment. Despite questions about the report's accuracy, there were many individuals who shared personal negative experiences suggesting that the public may feel directly impacted by error in the ED.

Keywords: diagnostic error; emergency care; misdiagnoses; public opinion.

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Conflict of interest statement

DMM receives funding from National Institute on Aging, National Institute on Drug Abuse, National Center for Complementary and Integrative Health, and the Agency for Healthcare Research and Quality. TJS and PK declare no conflicts of interest.

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