Knowledge of diagnostic errors in the PICU is limited. Future work to understand diagnostic errors should involve a balanced focus between studying the diagnosis of individual diseases and uncovering common system- and process-related determinants of diagnostic error.

Using independent tiered review, 396 abstracts were screened, and 17 studies (14 full-text, 3 abstracts) were ultimately included.

15 of 17 studies (88%) had an observational research design.

Autopsy studies (autopsy rates were 20–47%) showed a 10–23% rate of missed major diagnoses; 5–16% of autopsy-discovered diagnostic errors had a potential adverse impact on survival and would have changed management.

Retrospective record reviews reported varying rates of diagnostic error from 8% in a general PICU population to 12% among unexpected critical admissions and 21–25% of patients discussed at PICU morbidity and mortality conferences.

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