DX error by age groups

robert bell rmsbell at ESEDONA.NET
Tue Apr 30 18:07:13 UTC 2013


I wonder if there are any fairly accurate surrogates for medical errors including diagnostic.

We all forget something everyday.

For two days I collected all the ones that annoyed me, were somewhat inconvenient.

e.g.
Getting into the car in the garage and forgetting the letter to be mailed.
Driving off and forgetting to check that the garage door is down.

If I remember correctly I had 7 one day and 5 the next!!

Try it.

Beat me and then I will then divulge my age?!

Rob Bell



On Apr 30, 2013, at 10:48 AM, Lorri Zipperer wrote:

> From: Geoff Norman [mailto:norman at mcmaster.ca] 
> Sent: Tuesday, April 30, 2013 11:45 AM
> To: Society to Improve Diagnosis in Medicine; Henriksen, Kerm (AHRQ)
> Subject: Re: DX error by age groups
>  
> To continue answering the question that wasn't asked, Kevin Eva wrote a review article for Academic Medicine on the aging physician:
>  
> Acad Med. 2002 Oct;77(10 Suppl):S1-6.
> The aging physician: changes in cognitive processing and their impact on medical practice.
> Eva KW.
>  
> As to teaching / non-teaching latest Acad Med has an article on AMI survival rates, controlling for patient factors, and looking at community / minor teaching / major teaching. No significant differences.
>  
>  
> Geoff  
>  
> Geoff Norman
> norman at mcmaster.ca
>  
> MDCL 3519
> McMaster University
> 1200 Main St. W.
> Hamilton ON L8N3Z5, Canada
>  
> norman at mcmaster.ca
> (905) 525-9140, ext.22119
>  
>  
>  
> On 2013-04-30, at 11:07 AM, Henriksen, Kerm (AHRQ) wrote:
> 
> 
> Residency training is mentioned, so isn’t Geoff referring to practitioners? 
>  
>  
> Kerm Henriksen, PhD
> Human Factors Advisor for Patient Safety
> Agency for Healthcare Research and Quality
> 540 Gaither Road
> Rockville, MD 20850
>  
> e-mail:  Kerm.Henriksen at ahrq.hhs.gov
> phone: (301) 427-1331
> fax:        (301) 427-1341
>  
> From: Eta S Berner [mailto:eberner at UAB.EDU] 
> Sent: Tuesday, April 30, 2013 10:50 AM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: Re: DX error by age groups
>  
> I thought you meant by age of the patient, like are there likely to be more errors in kids, in the elderly etc.
>  
> *********************************************
> Eta S. Berner, Ed.D.
> Professor, Health Informatics
> Director, Center for Health Informatics for Patient Safety/Quality
> Department of Health Services Administration
> School of Health Professions
> Professor, Department of Medical Education
> School of Medicine
> University of Alabama at Birmingham
> 1675 University Blvd. #534
> Birmingham, AL 35294
> Phone: (205)975—8219
> Fax:       (205)975-6608
> Email:   eberner at uab.edu
>  
> From: Geoff Norman [mailto:norman at MCMASTER.CA] 
> Sent: Tuesday, April 30, 2013 9:35 AM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: Re: DX error by age groups
>  
> I have been tracking exactly this question for some time.. I have located probably 15 studies that address the question. First of all, it's easy to show a strong positive relationship with residency training, which is not the case if you look at measures like adherence to guidelines, ABIM performance etc. But beyond residency it's more tricky.I have not summarized the data quantitatively as yet, but I think the best guess is that there is a small negative relation between age and dx error, typically around -0.1.  And many outliers. In one study we did with elite internists, the best performer was 65, and the worst performer was 65. 
>  
> But a tantalizing possibility is that it may follow the "10,000" hour curve and be curvilinear, peaking at around 45. There's just not enough data to find this.
>  
>  
> Geoff  
>  
> Geoff Norman
> norman at mcmaster.ca
>  
> MDCL 3519
> McMaster University
> 1200 Main St. W.
> Hamilton ON L8N3Z5, Canada
>  
> norman at mcmaster.ca
> (905) 525-9140, ext.22119
>  
>  On 2013-04-30, at 5:46 AM, Jason Maude wrote:
> 
>  Hi to the new group.
> 
>  Does anybody know of any studies that show dx error by age group?
>  
> Many thanks 
>  
>  
> Jason Maude
> Founder and CEO Isabel Healthcare
> Tel: +44 1428 644886
> Tel: +1 703 879 1890
> www.isabelhealthcare.com
>  
> 
> 
> 
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> 
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