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Translational Healthcare Can Prevent Ambulatory Diagnostic Failures

 Francesco Chiappelli

Translational medicine, viz. translational healthcare, aims to obtain the best evidence base for improving the health of individuals and to utilize it in specific clinical settings in the community for diagnosis, intervention, policies and education. Diagnostic failures comprise a significant and costly fraction of all healthcare failures in the U.S. and globally with devastating consequences for all stakeholders. One timely and critical question for the continued evolution and establishment of translational healthcare nationally and internationally relates to the role translational healthcare can play in preventing diagnostic failures. Here, we present two clinical situations in dentistry, which have profound and significant systemic sequelae, to exemplify the extent to which the clinical dental sciences are intertwined with the clinical medical sciences. In one case (Ludwig angina cellulitis), the best evidence base obtained through translational effectiveness is discussed as key to preventing diagnostic failures; in the other (disorders of the temporomandibular joint), translational research holds promise as the critical factor in preventing diagnostic failures. Taken together, the case is made that preventable adverse events in healthcare do occur, among which failed diagnoses and misdiagnoses, which can cause serious bodily and financial harm to the patients and stakeholders. Research tools proffered by translational healthcare, if judiciously utilized in the context of GRADE and DECIDE, can serve to prevent ambulatory diagnostic failures. Operationally, we propose that the role of translational healthcare in preventing diagnostic failures must be articulated along the three distinct inter-related domains of (1) engagement of the stakeholders, (2) dissemination and (3)increased health literacy of the best evidence base.