disappointed

hmeisl48 hmeisl48 at GMAIL.COM
Thu Sep 24 02:58:28 UTC 2015


This is a lengthy document, and the authors go to great length to define 
a diagnostic error, but this entity is very difficult to define and 
still remains vague, especially their word "timely".
The source of their data includes autopsies, medical record reviews, 
malpractice claims, and also physician and patient surveys, which can be 
very subjective, depending on the survey responses and reviewers.
Hopefully this report will not lead to increased testing, with 
practitioners ordering every conceivable test to avoid a late or missed 
diagnosis. The authors excluded Overdiagnosis as a diagnostic error, 
which really should be part of a complete diagnostic approach to 
decrease patient harm.

However I welcome the emphasis on diagnostic accuracy, and one cannot 
argue with and can only agree with the general recommendations of 
Teamwork, Education of Health Care Providers, Patient Involvement etc.

Helmut Meisl




On 9/23/2015 9:31 AM, Robert L Wears, MD, MS, PhD wrote:
> Great that misdiagnosis and related failures are getting attention, but ...
>
> This is a disappointing effort; a naïve, keyhole view of a complex problem.
>
> I count 82 mentions of 'error' in the first 15 pages (~5.5 per page), 753 in the entire
> document.
>
> Lots of discussion about biases (78 mentions) but important issues that challenge the focus
> on 'error', such as hindsight bias, or outcome bias, are never mentioned even once.
>
> This restriction to a very narrow framing of the problem is unlikely to lead to progress.
>
> bob
>
>
>
> Robert L Wears, MD, MS, PhD
> University of Florida  	Imperial College London
> wears at ufl.edu		r.wears at imperial.ac.uk
> 1-904-244-4405 (ass't)  	+44 (0)791 015 2219
> Nothing matters very much, and very few things matter at all.
>                                                    ---Balfour
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>
> Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine
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