quick ?

Robert M Centor rcentor at UAB.EDU
Wed Apr 23 19:51:43 UTC 2014


Steve,

Great to have you stimulating this discussion!

I think the question is impossible to answer.  Diagnostic error rates are very difficult to measure, and easy to criticize.  Clearly diagnostic errors have great importance, and more importance for some presentations than others.

Anecdotally, community acquired pneumonia admitted to a hospitalist service has a relatively high diagnostic error rate, while diabetic foot ulcer has a much lower rate.  Rates must vary according to presenting symptoms, the relative challenge in making the diagnosis, the perceived importance of the presenting complaint (by both the patient and the physicians), the physician’s expertise, etc.

Diagnostic errors are too common, but trying to estimate a number seems inappropriate.

Bob
==============

Robert M Centor, MD, FACP

Regional Dean, UAB Huntsville Regional Medical Campus
301 Governors Drive
Huntsville, AL 35801

Office: 256-539-7757
Fax: 256-551-4451

Chair, ACP Board of Regents

Professor, General Internal Medicine
UAB
FOT 720
1530 3rd Ave S
Birmingham, AL 35294-3407


From: <Pauker>, Stephen <SPauker at TUFTSMEDICALCENTER.ORG<mailto:SPauker at TUFTSMEDICALCENTER.ORG>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, "Pauker, Stephen" <SPauker at TUFTSMEDICALCENTER.ORG<mailto:SPauker at TUFTSMEDICALCENTER.ORG>>
Date: Wednesday, April 23, 2014 at 11:01 AM
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [IMPROVEDX] quick ?

What # is quoted for freq of diag errors in routine practice
without reference to selection bias??

I think I heard a news story quoting something like 40% of encounters or patients.
Hard to believe that # which seems grossly inflated

Steve

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