Diagnostic Errors in the Critically Ill

• Critical illness comprises numerous time-sensitive conditions in which diagnostic errors and delayed diagnoses markedly impact patient outcomes.
• Diagnostic errors in the critically ill can occur in up to 20% of patients and lead to overuse of resources, delayed recovery, and increased mortality.
• The most common cognitive biases leading to diagnostic errors in the critically ill include: 
  • Anchoring bias: over-reliance on your initial impressions
  • Availability bias: favoring diagnoses that easily come to mind
  • Premature closure: ending your diagnostic reasoning too early
  • Confirmation bias: seeking information that supports your diagnosis and discounting contradictory findings
• Recommended strategies to reduce diagnostic errors in the critically ill include implementation of checklists, standardized handoff protocols, multidisciplinary patient reviews, and explicitly discussing these cognitive biases.

References

Valentin A, et al. Exploring the dark side of the moon: diagnostic errors in critically ill patients. Intensive Care Med. 2025; 51:2422-5.