Document Detail

Diagnostic decision-making and strategies to improve diagnosis.
MedLine Citation:
PMID:  24070580     Owner:  NLM     Status:  In-Data-Review    
A significant portion of diagnostic errors arises through cognitive errors resulting from inadequate knowledge, faulty data gathering, and/or faulty verification. Experts estimate that 75% of diagnostic failures can be attributed to clinician diagnostic thinking failure. The cognitive processes that underlie diagnostic thinking of clinicians are complex and intriguing, and it is imperative that clinicians acquire explicit appreciation and application of different cognitive approaches to make decisions better. A dual-process model that unifies many theories of decision-making has emerged as a promising template for understanding how clinicians think and judge efficiently in a diagnostic reasoning process. The identification and implementation of strategies for decreasing or preventing such diagnostic errors has become a growing area of interest and research. Suggested strategies to decrease diagnostic error incidence include increasing clinician's clinical expertise and avoiding inherent cognitive errors to make decisions better. Implementing Interventions focused solely on avoiding errors may work effectively for patient safety issues such as medication errors. Addressing cognitive errors, however, requires equal effort on expanding the individual clinician's expertise. Providing cognitive support to clinicians for robust diagnostic decision-making serves as the final strategic target for decreasing diagnostic errors. Clinical guidelines and algorithms offer another method for streamlining decision-making and decreasing likelihood of cognitive diagnostic errors. Addressing cognitive processing errors is undeniably the most challenging task in reducing diagnostic errors. While many suggested approaches exist, they are mostly based on theories and sciences in cognitive psychology, decision-making, and education. The proposed interventions are primarily suggestions and very few of them have been tested in the actual practice settings. Collaborative research effort is required to effectively address cognitive processing errors. Researchers in various areas, including patient safety/quality improvement, decision-making, and problem solving, must work together to make medical diagnosis more reliable.
Satid Thammasitboon; William B Cutrer
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current problems in pediatric and adolescent health care     Volume:  43     ISSN:  1538-3199     ISO Abbreviation:  Curr Probl Pediatr Adolesc Health Care     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-09-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101134613     Medline TA:  Curr Probl Pediatr Adolesc Health Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  232-41     Citation Subset:  IM    
Copyright Information:
© 2013 Mosby, Inc. All rights reserved.
Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin St, W-6006, Houston, TX 77030.
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