Cognitive Autopsy in Emergency Medicine

Fried, Ethan Efried1 at NSHS.EDU
Wed Oct 22 16:54:24 UTC 2014


The bias you are referring to is discussed frequently as "Visceral bias" which results from counter transference toward a patient who is too nice to have a grave diagnosis.  Your other example I've seen referred to as "availability bias" when the clinician bases a denial of a diagnosis on having not previously seen an illness or "base rate neglect" which involves not really knowing the true prevalence and so underestimating the odds that it's in your office now.

But I like the more encompassing label of "denial" too.

Ethan D. Fried, MD, MACP
Residency Program Director and Associate Chair for Education, Medicine - Lenox Hill Hospital
Associate Designated Institutional Official
North Shore/LIJ Health System
Associate Professor of Medicine, Hofstra North Shore-LIJ School of Medicine
100 East 77th Street, 6 Black Hall, New York, NY  10075
P:  212-434-4833, 212-434-3873
F:  212-434-2446, 212-434-6359
Cell:  516-680-7570, E:  efried1 at nshs.edu

Find us online: northshorelij.com<http://www.northshorelij.com/hospitals/home>
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From: Ruth Ryan [mailto:rryan at LAMMICO.COM]
Sent: Tuesday, October 21, 2014 2:06 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] Cognitive Autopsy in Emergency Medicine

The current issue of the Sullivan Group or TSG Newsletter aimed at emergency medicine carries an article about a case of missed diagnosis of Long QT Syndrome and does a cognitive autopsy. Click here https://www.thesullivangroup.com/risk_resources/newsletters/TSGFall2014Newsletter.pdf

Question about cognitive autopsies: why don't we see "Denial" listed among the cognitive biases and errors in diagnosis? We see denial and sometimes paralysis in serious events (I can't believe this charming patient could have a grave diagnosis; I'm not really seeing postpartum hemorrhage; my patient's not having a post op complication from a bile duct I nicked; I can't possibly be seeing the first case of Ebola diagnosed in the US, etc.)

Ruth
Ruth Ryan RN, BSN, MSW, CPHRM
Senior Risk Management Education Specialist
LAMMICO
1 Galleria Blvd., Suite 700
Metairie, LA 70001
E-Mail rryan at lammico.com<mailto:rryan at lammico.com>
Telephone (504) 841-2736
Fax (504) 841-5312


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