Special Emphasis Notice (SEN): Health Services Research Priorities for Improving Diagnostic Safety and Quality

Notice Number:


Key Dates

Release Date: December 27, 2019

Related Announcements




Issued by

Agency for Healthcare, Research and Quality (AHRQ)


The purpose of this notice is to inform the research community about AHRQ’s continued interest in the following areas of research (Note: These areas of interest were also described in RFA-HS-19-003, which is available at (https://grants.nih.gov/grants/guide/rfa-files/RFA-HS-19-003.html):

Establishing the incidence of diagnostic errors, understanding the contributing factors for those errors for unique clinical conditions and health care settings, and understanding the association between diagnostic errors and outcomes (e.g., adverse events, cost, and utilization).

Contributing factors may include, but are not limited to, socio-demographic, socio-economic, and other characteristics of patients, the clinical infrastructure (e.g., availability and access to resources and technologies to diagnose patients, decision support systems, and Electronic Health Records), healthcare system organizational, case management and financial arrangements (ACOS, PCMHs), market characteristics, PCP/Specialty Ratios, patient engagement, family engagement, communication, literacy, numeracy, transitions, and existing safety practices. Proposed research projects should provide information about diagnostic processes and clinical variation in the nature, timing, volume, and sequence of events leading up to diagnoses. This may further inform the definition of a diagnostic error, and provide a means for classification based on deviation from a norm and/or the outcome of an error.

It would be important for investigators to utilize existing data sources such as Electronic Health Records (EHRs), patient registries, virtual data enterprises, etc., as the principal source of data for the proposed research projects. Linkages and collection of additional data are also encouraged to support the research aims. Depending on the research project, predictive modeling may be employed to forecast diagnostic errors or outcomes. Approaches and/or outcomes will require validation, although some studies may be more inductive in nature. A multidisciplinary approach is encouraged, and the investigators should consider including physicians, nurses, other clinicians, health services researchers, data scientists, data engineers, computer scientists, content experts, statisticians in the research plan. Applications responding to this SEN can request support for analyzing previously collected data that would benefit from further exploration and to advance scientific knowledge of diagnostic safety and quality by applying contemporary approaches to model existing data.

Applicants intending to address areas of research described in this SEN are encouraged to develop specific partnerships to achieve their aims. Partnerships may be established primarily for the purpose of acquiring and/or providing necessary data and analytic expertise to answer the research question. Partners could include various stakeholders such as academic institutions, health care delivery systems, payers, medical and clinical societies, patients and patient organizations, malpractice carriers and healthcare risk management organizations, EHR vendors and others. The rationale for proposed partnerships should be described, including the enhanced capabilities partnerships will create and the added value that shared work on the project will generate.


Please direct all inquiries to:

Stephen Raab
Health Scientist Administrator
Agency for Healthcare, Research and Quality (AHRQ)
Center for Quality Improvement and Patient Safety (CQuIPS)
Tel: 301-427-1515
Email: stephen.raab@ahrq.hhs.gov