Navigation Links
Will you be misdiagnosed? -- how diagnostic errors happen
Date:4/28/2008

New York, April 28, 2008 How frequently do doctors misdiagnose patients? While research has demonstrated that the great majority of medical diagnoses are correct, the answer is probably higher than patients expect and certainly higher than doctors realize. In a Supplement to the May issue of The American Journal of Medicine, a collection of articles and commentaries sheds light on the causes underlying misdiagnoses and demonstrates a nontrivial rate of diagnostic error that ranges from <5% in the perceptual specialties (pathology, radiology, dermatology) up to 10% to 15% in many other fields.

The sensitive issue of diagnostic error is rarely discussed and has been understudied. The papers in this volume confirm the extent of diagnostic errors and suggest improvement will best come by developing systems to provide physicians with better feedback on their own errors.

Guest Editors Mark L. Graber, MD, FACP (Veterans Affairs Medical Center, Northport, NY and Department of Medicine, SUNY Stony Book) and Eta S. Berner, EdD (School of Health Professions, University of Alabama at Birmingham) oversaw the development and compilation of these papers. Drs. Berner and Graber conducted an extensive literature review concerning teaching, learning, reasoning and decision making as they relate to diagnostic error and overconfidence and developed a framework for strategies to address the problem.

They write, Given that physicians overall are highly dedicated and well-intentioned, we believe that if they were more aware of these factors and their own predisposition to error, they would adopt behaviors and attitudes that would help decrease the likelihood of diagnostic error. Being confident even when in error is an inherent human trait, and physicians are no exception. The fact that most of their diagnoses are correct, and that effective feedback regarding their errors is lacking, reinforces this inclination. When directly questioned, many clinicians find it inconceivable that their own error rate could be as high as the literature demonstrates. They acknowledge that diagnostic error exists, but believe the rate is very low, and that any errors are made by others who are less skillful or less careful. This reflects both overconfidence and complacency. In medicine, the challenge is to reduce the complacency and overconfidence that leads to failure to recognize when ones diagnosis is incorrect.

Dr. Pat Croskerry and Dr. Geoff Norman review two modes of clinical reasoning to understand the processes underlying overconfidence. Ms. Beth Crandall and Dr. Robert L. Wears highlight gaps in knowledge about the nature of diagnostic problems, emphasizing the limitations of applying static models to the messy world of clinical practice.

In any endeavor, "Learning and feedback are inseparable," according to Dr. Gordon L. Schiff, who discusses the numerous barriers to adequate feedback and follow-up in the real world of clinical practice. Taking another approach, Dr. Jenny W. Rudolph and Dr. J. Bradley Morrison provide an expanded model of the fundamental feedback processes involved in diagnostic problem solving, highlighting particular leverage points for avoiding error. In the final commentary, Dr. Graber identifies stakeholders interested in medical diagnosis and provides recommendations to help each reduce diagnostic error.

These papers also emphasize a second theme. Medical practitioners really do not use systems designed to aid their diagnostic decision making. From early systems in the 1980s to more recent efforts, physicians have underutilized decision-support systems and misdiagnosis rates remain high.

Donald A.B. Lindberg, MD, Director of the National Library of Medicine, writes in an introduction to the Supplement, I sympathize with and respectfully salute these present efforts to study diagnostic decision making and to remedy its weaknessesI applaud especially the suggestions to systematize the incorporation of the downstream experiences and participation of the patients in all efforts to improve the diagnostic process.

In my view, diagnostic error will be reduced only if physicians have a more realistic understanding of the amount of diagnostic errors they PERSONALLY make, summarizes Paul Mongerson, who created a foundation to promote computer-based and other strategies to reduce diagnostic errors. I believe that the accuracy of diagnosis can be best improved by informing physicians of the extent of their own (not others) errors and urging them to personally take steps to reduce their own errors.


'/>"/>

Contact: Pamela Poppalardo
ajmmedia@elsevier.com
212-633-3944
Elsevier Health Sciences
Source:Eurekalert

Related medicine news :

1. Increase in Diagnostic Imaging Fueled by Self-Referring Doctors
2. Quest Diagnostics Reports Strong Revenue and Earnings Growth in First Quarter 2008
3. Innovative Diagnostic Instrument Introduced by Abbott for Low- to Mid-Volume Laboratory Market Segment
4. Allegro Diagnostics Announces Publication in Cancer Prevention Research of Prediction Model for Lung Cancer Diagnosis Integrating Clinical and Genomic Features
5. Quest Diagnostics to Release First Quarter 2008 Financial Results and Conduct Quarterly Investor Conference Call
6. Salivary diagnostics, the magic mirror to your health ... at your personal computer
7. Gen-Probe to Webcast Presentation at Leerink Swann Molecular Diagnostics Conference
8. Dominion Diagnostics Announces Launch of Comprehensive New Company Website
9. PET confirmed as valuable cancer diagnostic and disease-staging tool
10. FASgen Diagnostic Tests Identify Ovarian Cancer Progression and Apoptosis
11. BD to Present at the Leerink Swann Molecular Diagnostics Roundtable Conference
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/27/2016)... ... May 27, 2016 , ... Two director-level employees of ... Tribute to Women and Industry (TWIN) 2016 honorees. The award recognizes businesswomen who ... this year, Geri Boone, Director of the MLTSS (Managed Long-Term Services and Supports) Program ...
(Date:5/27/2016)... ... 27, 2016 , ... This campaign aims to provide a path to improved ... can control and change. , As nearly 795,000 Americans suffering from a new or ... States. Plus, with an estimated 129,000 of these people dying from stroke, it’s become ...
(Date:5/27/2016)... ... May 27, 2016 , ... Aimed at nurses ... human interest stories, courtesy of leaders in the nursing and health care industry. ... from leading advocates and associations—namely Jones & Bartlett Learning. , Jones & Bartlett ...
(Date:5/26/2016)... (PRWEB) , ... May 26, 2016 , ... Despite last ... meeting, expect Janet Yellen and company to wait until March 2017 for an interest ... University’s J. Mack Robinson College of Business. , “The Federal Open Market Committee (FOMC) ...
(Date:5/26/2016)... ... May 26, 2016 , ... ... hosted members and suppliers for its inaugural Member Conference at the Paris Hotel ... of elevating the operational health of America’s healthcare providers. , The conference was ...
Breaking Medicine News(10 mins):
(Date:5/26/2016)... A key trend that will ... of new treatments. Cardax, a development stage life sciences ... therapy is expected to fulfil large unmet medical needs ... studies to develop new treatments for osteoarthritis. One such ... in osteoarthritis are being investigated, and early trials of ...
(Date:5/25/2016)... FDA 510(k) clearance covers Confocal Miniprobes ... and surgical applications Mauna Kea Technologies ... multidisciplinary confocal laser endomicroscopy (CLE) platform, today announced ... the 12 th 510(k) clearance from United ... FDA clearance covers Confocal Miniprobes indicated for use ...
(Date:5/25/2016)...  Zymo Research Corp. announced today the final ... that help researchers obtain the most accurate and ... rapid growth of the study of microbiomes has ... methods to improve the reproducibility and quality of ... every step of the measurement process including collection ...
Breaking Medicine Technology: