File Name: the importance of cognitive errors in diagnosis and strategies to minimize them .zip
- Diagnostic error, overconfidence and self-knowledge
- Diagnostic Error in Internal Medicine
- Diagnostic error, overconfidence and self-knowledge
Diagnostic Error in Internal Medicine. Arch Intern Med.
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Diagnostic error, overconfidence and self-knowledge
It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results. Azer SA. Acad Med. Problem-based learning: a review of literature on its outcomes and implementation issues.
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Diagnostic Error in Internal Medicine
Medical error is a leading cause of death nationwide. While systems issues have been closely investigated as a contributor to error, little is known about the cognitive factors that contribute to diagnostic error in an emergency department ED environment. Eight months of patient revisits within 72 h where patients were admitted on their second visit were examined. Fifty-two cases of confirmed error were identified and classified using a modified version of the Australian Patient Safety Foundation classification system for medical errors by a group of trained physicians. Despite the complex nature of diagnostic reasoning, cognitive errors of information processing appear to occur at higher rates than other errors, and in a similar pattern to an internal medicine service despite a different clinical environment. Further research is needed to elucidate why these errors occur and how to mitigate them.
Confirmation bias is the tendency to search for, interpret, favor, and recall information in a way that confirms or supports one's prior beliefs or values. The effect is strongest for desired outcomes, for emotionally charged issues, and for deeply entrenched beliefs. Confirmation bias cannot be eliminated entirely, but it can be managed, for example, by education and training in critical thinking skills. Confirmation bias is a broad construct covering a number of explanations. Biased search for information, biased interpretation of this information, and biased memory recall, have been invoked to explain four specific effects: 1 attitude polarization when a disagreement becomes more extreme even though the different parties are exposed to the same evidence ; 2 belief perseverance when beliefs persist after the evidence for them is shown to be false ; 3 the irrational primacy effect a greater reliance on information encountered early in a series ; and 4 illusory correlation when people falsely perceive an association between two events or situations. A series of psychological experiments in the s suggested that people are biased toward confirming their existing beliefs.
In the area of patient safety, recent attention has focused on diagnostic error. The reduction of diagnostic error is an important goal because of its associated morbidity and potential preventability. A critical subset of diagnostic errors arises through cognitive errors, especially those associated with failures in perception, failed heuristics, and biases; collectively, these have been referred to as cognitive dispositions to respond CDRs. Historically, models of decision-making have given insufficient attention to the contribution of such biases, and there has been a prevailing pessimism against improving cognitive performance through debiasing techniques. Recent work has catalogued the major cognitive biases in medicine; the author lists these and describes a number of strategies for reducing them "cognitive debiasing". Principle among them is metacognition, a reflective approach to problem solving that involves stepping back from the immediate problem to examine and reflect on the thinking process. Further research effort should be directed at a full and complete description and analysis of CDRs in the context of medicine and the development of techniques for avoiding their associated adverse outcomes.
The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. Aug;78(8) doi: /
Diagnostic error, overconfidence and self-knowledge
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Mathieu Nendaz a,b , Arnaud Perrier a. The majority of cognitive errors are not related to knowledge deficiency but to flaws in data collection, data integration, and data verification that may lead to premature diagnostic closure. This paper reviews some aspects of the literature on cognitive psychology that help us to understand reasoning processes and knowledge organisation and summarises biases related to clinical reasoning.
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