Identification and analysis of the evidence gaps in the field of diagnostic errors research in Japan: a scoping review

OBJECTIVES: This scoping review aimed to identify and map the existing evidence for the status of diagnostic errors in adult patients in Japan. METHODS: This scoping review included studies investigating diagnostic errors in adult patients in Japan since 1999; we followed an established framework for conducting scoping reviews. Data were extracted from searches of the MEDLINE, Web of Science, and Ichushi-Web databases. No language restrictions were imposed. The review considered all study types as eligible, except case reports or case series. Study selection and data extraction were conducted by pairs of independent reviewers, with a third reviewer involved in resolving disagreements. RESULTS: This review included 257 full-text articles. The first authors' most common department was orthopedics (n=50). The most common data resource was manual chart review (n=165). The most common disease category was neoplasms (n=44). The definitions or measurements of diagnostic errors were described in 241 articles. However, the definitions of diagnostic errors varied widely among studies, even those examining the same disease. CONCLUSIONS: The status and challenges of research on diagnostic errors in Japan were clarified. To date, few studies have comprehensively assessed the national landscape of diagnostic errors. Developing standardized, comparable metrics and establishing a unified framework for understanding diagnostic errors, for broad dissemination and implementation at a national scale, remain pressing priorities.