Stethoscopes contribution to diagnostic errors

Hoffer, Edward P.,M.D. EHOFFER at MGH.HARVARD.EDU
Thu Mar 26 11:50:11 UTC 2015


Over 40 years ago, a friend of mine,  Dr. Robert Hirschfeld, then a medical student, wrote a program to do Baysean diagnosis of congenital heart disease. The user input the auscultatory findings and the program indicated the diagnosis. When medical students used it, it was about 40% accurate. When residents used it, it was about 60% accurate and when cardiologists used it, it was about 85% accurate.
Garbage In=Garbage out.
Ed

Edward P Hoffer MD, FACP, FACC

________________________________________
From: robert bell [0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG]
Sent: Wednesday, March 25, 2015 10:09 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] Stethoscopes contribution to diagnostic errors

Should physicians/HCPs be checked before being able/allowed to use a  stethoscope?  Should they be cleared for hearing loss before being allowed to use a stethoscope?  This would seem to be so very important with so much high frequency hearing loss in young people.

I have the idea that many errors in diagnosis are associated with stethoscope decisions.

It would seem that there are tremendous differences between a First Year Medical student with or without hearing loss, a fourth year medical student, with or without hearing loss, a 2nd year resident, with or without hearing loss, a practicing physician with or with our hearing loss, and a cardiologist of 30 years experience, with or without hearing loss.

Should we not address the basics before we move further ahead in trying to reduce diagnostic errors?

Do we know what the error rates are in various groups of HCPs who use stethoscopes?

Rob B






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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine




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