Definitions and Measurements for Atypical Presentations at Risk for Diagnostic Errors in Internal Medicine: Protocol for a Scoping Review (Preprint)

Abstract

BACKGROUND Atypical presentations have been increasingly recognized as a significant contributing factor to diagnostic errors in internal medicine. However, research to address associations of atypical presentations and diagnostic errors have not been well explored due to the lack of widely applicable definitions and criteria for what is considered an atypical presentation. OBJECTIVE To describe how atypical presentations are defined and measured in studies of diagnostic errors in internal medicine and use this new information to develop new criteria to identify atypical presentations at high risk for diagnostic errors. METHODS This scoping review will include research investigating the association between atypical presentations and diagnostic errors in the internal medicine setting. This study will follow an established framework for conducting scoping reviews. The data will be extracted through MEDLINE, Web of Science, CINAHL, Embase, The Cochrane Library, and Google Scholar searches. No limits will be applied to language, and articles indexed from database inception to December 31st, 2023 will be included. Two independent reviewers will conduct study selection and data extraction. RESULTS The extracted data will be presented in tabular format with descriptive statistics, and from this, the key components or types of atypical presentations—the purpose of this scoping review—will be identified to develop new criteria to identify atypical presentations for future studies of diagnostic errors. Developing the new criteria will follow a guidance for a basic qualitative content analysis with an inductive approach. CONCLUSIONS This scoping review will provide the evidence summary to describe how atypical presentations are defined and measured in studies of diagnostic errors in internal medicine and develop new criteria to identify atypical presentations at high risk for diagnostic errors. CLINICALTRIAL doi:10.17605/OSF.IO/27D5M