Stethoscopes contribution to diagnostic errors

Alan Morris Alan.Morris at IMAIL.ORG
Thu Mar 26 13:41:42 UTC 2015


Dr. Hoffer.
Can you point me to citations / references or the program itself.
I am interested in examining the data you cite.
Alan H. Morris, M.D.
Professor of Medicine
Adjunct Prof. of Medical Informatics
University of Utah

Director of Research
Pulmonary/Critical Care Division
Sorenson Heart & Lung Center - 6th Floor
Intermountain Medical Center
5121 South Cottonwood Street
Murray, Utah  84157-7000, USA

Office Phone: 801-507-4603
Mobile Phone: 801-718-1283




On 3/26/15, 5:50 AM, "Hoffer, Edward P.,M.D." <EHOFFER at MGH.HARVARD.EDU>
wrote:

>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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