@article {644934,
	title = {Association Between Physician Depressive Symptoms and Medical Errors: A Systematic Review and Meta-analysis},
	journal = {JAMA Netw Open},
	volume = {2},
	number = {11},
	year = {2019},
	month = {2019 Nov 01},
	pages = {e1916097},
	abstract = {Importance: Depression is highly prevalent among physicians and has been associated with increased risk of medical errors. However, questions regarding the magnitude and temporal direction of these associations remain open in recent literature.

Objective: To provide summary relative risk (RR) estimates for the associations between physician depressive symptoms and medical errors.

Data Sources: A systematic search of Embase, ERIC, PubMed, PsycINFO, Scopus, and Web of Science was performed from database inception to December 31, 2018.

Study Selection: Peer-reviewed empirical studies that reported on a valid measure of physician depressive symptoms associated with perceived or observed medical errors were included. No language restrictions were applied.

Data Extraction and Synthesis: Study characteristics and RR estimates were extracted from each article. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using subgroup meta-analysis and metaregression. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed.

Main Outcomes and Measures: Relative risk estimates for the associations between physician depressive symptoms and medical errors.

Results: In total, 11 studies involving 21 517 physicians were included. Data were extracted from 7 longitudinal studies (64\%; with 5595 individuals) and 4 cross-sectional studies (36\%; with 15 922 individuals). The overall RR for medical errors among physicians with a positive screening for depression was 1.95 (95\% CI, 1.63-2.33), with high heterogeneity across the studies (χ2 = 49.91; P ,
	issn = {2574-3805},
	doi = {10.1001/jamanetworkopen.2019.16097},
	author = {Pereira-Lima, Karina and Mata, Douglas A and Loureiro, Sonia R and Crippa, Jos{\'e} A and Bolsoni, L{\'\i}via M and Sen, Srijan}
}
