FW: DX error by age groups
Lorri at ZPM1.COM
Wed May 1 15:58:25 UTC 2013
From: Meier, Frederick [mailto:FMEIER1 at hfhs.org]
Sent: Wednesday, May 01, 2013 9:46 AM
To: 'Society to Improve Diagnosis in Medicine'; 'Kathryn Montgomery'
Subject: RE: DX error by age groups
KM--That's a keen observation; Aristotelean [rather than modern]
understanding of ' habit' [the improving effect of right practice] fits in
From: Kathryn Montgomery [mailto:kmontgomery at NORTHWESTERN.EDU]
Sent: Tuesday, April 30, 2013 9:08 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: DX error by age groups
Aristotle talks about it too-- in the Nicomachean Ethics. He says that
phronesis--which maps fairly well onto system 1 thinking--is emphatically
NOT the property of the young. Hence the hothouse of residency training?
Kathryn Montgomery, PhD
Julia and David Uihlein Professor of Medical Humanities and Bioethics
Professor of Medicine
Director of Graduate Studies in Medical Humanities and Bioethics
750 North Lake Shore Drive - Suite 625
Chicago, Illinois 60611, USA bioethics.northwestern.edu
On Apr 30, 2013, at 2:00 PM, Geoff Norman wrote:
The issue of aging is central to a dual processing model (Eva talks about
this). It's one thing to show formal knowledge, adherence to guidelines,
etc. falls off with age (The Ramsey, Leigh, Norcini and Day studies as well
as Choudhry). But it's another to show that diagnostic errors go up with
age, as with increasing age/experience docs rely more on system 1, which is
mainly based on direct experience, and presumably goes up with age. It could
be then, that the almost flat line between age and accuracy (if it is a flat
line) is a sum of a decaying formal knowledge and an increasing experiential
knowledge. Also a good reason to look for curvilinearity.
BTW, the Choudhry article contains a major error wrt . the Norcini study of
mortality rates in CCU. See my letter to editor.
norman at mcmaster.ca
1200 Main St. W.
Hamilton ON L8N3Z5, Canada
norman at mcmaster.ca
(905) 525-9140, ext.22119
On 2013-04-30, at 1:49 PM, Randolph Miller wrote:
Here are a few old references
Ramsey PG, Carline JD, Inui TS, Larson, LoGerfo JP, Norcini JJ, Wenrich MD.
Changes over time in the knowledge base of practicing internists. JAMA.
Leigh TM, Young PR, Haley JV. Performances of family practice diplomates on
successive mandatory recertification examinations. Acad Med.
-- Randy Miller
On Apr 30, 2013, at 4:46 AM, Jason Maude <Jason.Maude at ISABELHEALTHCARE.COM>
Hi to the new group.
Does anybody know of any studies that show dx error by age group?
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890
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