AUTHOR=McDonald Kathryn M. , Gleason Kelly T. , Grob Rachel N. , Yuan Christina T. , Dhingra Isha , Evered Jane A. , Warne Emily M. , Schlesinger Mark 

TITLE=Exploring sociodemographic disparities in diagnostic problems and mistakes in the quest for diagnostic equity: insights from a national survey of patient experiences

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1444005

DOI=10.3389/fpubh.2025.1444005

ISSN=2296-2565

ABSTRACT=IntroductionAs part of building a platform for epidemiological research on diagnostic errors and problems that centers on patients and equity, this paper summarizes the development and analysis of data collected from fielding a survey in a nationally representative U.S. population to explore the prevalence and harm consequences of diagnostic problems or mistakes (referred to here as “diagnostic P&Ms”) by respondent-reported sociodemographic characteristics.MethodsWe applied narrative elicitation methods to enhance the rigor of implementing a novel survey about diagnostic experiences. We conducted a U.S. population-based survey of a nationally representative sample in 2022–2023, drawn from the NORC AmeriSpeak® panel. We conducted multivariate regression analysis at the household level and in a patient subsample to explore sociodemographic predictors of diagnostic P&Ms and related outcomes in the aftermath.ResultsThe comparative analysis by sociodemographic characteristics estimates prevalence of diagnostic P&Ms, prevalence of persisting harms, rate of respondent-reported perceptions of personal attribute adversely affecting diagnosis, and concern about future diagnostic P&Ms. Outcome estimates ranged from about 4% (concern about future diagnostic P&M) to 38% (at least one P&M in households during the past 4 years). Several sociodemographic groups experienced statistically significant higher levels of risk for these outcomes, with some at greater than twice the odds compared to reference groups—transgender and gender independent individuals (e.g., 5 + −fold odds of expectation of future P&M compared to cis-males), cis-females (e.g., greater than 1.5 odds of persistent physical and emotional harms compared to cis-males), low household income (e.g., twice the likelihood of multiple P&Ms for incomes under $60 K compared to $100 K+ households), younger age (3-fold odds of at least one diagnostic P&M for those under 25 years old compared to those aged 45–54), multiracial individuals (about twice the odds of diagnostic P&Ms compared to non-Hispanic White), and disabled and unable to work full-time (more than twice the likelihood of perceiving that a personal attribute impaired diagnosis compared to those with other work status designations).DiscussionThis new survey and accompanying data source facilitate an enriched exploration of the patterns of diagnostic disparities and points of leverage through which diagnostic experiences can be made more equitable.