DX error by age groups

Robert McNutt Robert_McNutt at RUSH.EDU
Tue Apr 30 19:12:01 UTC 2013


If we begin to hold ourselves to unattainable standards we will begin to damage. Error is unmeasurable and hence not subject yet to any standard of scientific credibility. We should be sanguine about judging ourselves and other. My view anyway.

Sent from my iPhone

On Apr 30, 2013, at 1:12 PM, "robert bell" <rmsbell at ESEDONA.NET<mailto:rmsbell at ESEDONA.NET>> wrote:

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.<http://www.ncbi.nlm.nih.gov/pubmed/12377689> 2002 Oct;77(10 Suppl):S1-6.
The aging physician: changes in cognitive processing and their impact on medical practice.
Eva KW<http://www.ncbi.nlm.nih.gov/pubmed?term=Eva%20KW%5BAuthor%5D&cauthor=true&cauthor_uid=12377689>.

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<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 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<mailto: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<mailto: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<mailto: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<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/>


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To learn more about SIDM visit:
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Save the date: Diagnostic Error in Medicine 2013. September 22-25, 2013 in Chicago, IL.
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