DX error by age groups

Thomas, Eric Eric.Thomas at UTH.TMC.EDU
Tue Apr 30 18:52:51 UTC 2013


Here are two studies that I have been involved in that partially answer your question.  For inpatients in the UT and CO Medical Practice Study there were not more diagnostic errors in the elderly (Table 3 in the second paper below), but in our recent study in the outpatient setting there were more (Table 1, first paper below).  I think that most clinicians would say they are more common in the elderly simply because their care is more complex.

Types and origins of diagnostic errors I primary care settings.  Singh H, Giardina TD, Meyer AN, Forjuoh SN, Reis MD, Thomas EJ.  JAMA Intern Med. 2013 Mar 25;173(6):418-25. PMID:23440149.

Thomas EJ, Brennan TA. Incidence and types of preventable adverse events in elderly patients: population based review of medical records.  BMJ. 2000 Mar 18;320(7237):741-4.
PMID:10720355

Eric

Eric J Thomas MD, MPH
Professor of Medicine
Associate Dean for Healthcare Quality
Director, UT Houston-Memorial Hermann Center for Healthcare Quality and Safety
The University of Texas Medical School at Houston
6410 Fannin UPB 1100.44
Houston, TX 77030
713-500-7958
www.utpatientsafety.org<http://www.utpatientsafety.org/>




From: Jason Maude [mailto:Jason.Maude at ISABELHEALTHCARE.COM]
Sent: Tuesday, April 30, 2013 10:11 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: DX error by age groups

I did mean by patient age but realise that by practitioner age is also an interesting question.


From: Bradford Winters <bwinters at JHMI.EDU<mailto:bwinters at JHMI.EDU>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, Bradford Winters <bwinters at JHMI.EDU<mailto:bwinters at JHMI.EDU>>
Date: Tuesday, 30 April 2013 15:50
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: Re: DX error by age groups

Did you mean by patient age or practitioner age?

Bradford D. Winters, Ph.D., M.D.
________________________________
From: Geoff Norman [norman at MCMASTER.CA<mailto:norman at MCMASTER.CA>]
Sent: Tuesday, April 30, 2013 10:35 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto: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<mailto:norman at mcmaster.ca>

MDCL 3519
McMaster University
1200 Main St. W.
Hamilton ON L8N3Z5, Canada

norman at mcmaster.ca<mailto: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<http://www.isabelhealthcare.com/>

________________________________

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1

or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX


Moderator: Lorri Zipperer Lorri at ZPM1.com<mailto:Lorri at ZPM1.com>, Communication co-chair, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/


Save the date: Diagnostic Error in Medicine 2013. September 22-25, 2013 in Chicago, IL.
http://www.improvediagnosis.org/?page=DEM_2013/



________________________________

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX

Moderator: Lorri Zipperer Lorri at ZPM1.com<mailto:Lorri at ZPM1.com>, Communication co-chair, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/

Save the date: Diagnostic Error in Medicine 2013. September 22-25, 2013 in Chicago, IL.
http://www.improvediagnosis.org/?page=DEM_2013

________________________________

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX

Moderator: Lorri Zipperer Lorri at ZPM1.com<mailto:Lorri at ZPM1.com>, Communication co-chair, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/

Save the date: Diagnostic Error in Medicine 2013. September 22-25, 2013 in Chicago, IL.
http://www.improvediagnosis.org/?page=DEM_2013

________________________________

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX

Moderator: Lorri Zipperer Lorri at ZPM1.com<mailto:Lorri at ZPM1.com>, Communication co-chair, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/

Save the date: Diagnostic Error in Medicine 2013. September 22-25, 2013 in Chicago, IL.
http://www.improvediagnosis.org/?page=DEM_2013








HTML Version:
URL: <../attachments/20130430/8a756d29/attachment.html>


More information about the Test mailing list