Diagnostic errors related to acute abdominal pain in the emergency department.

Ruth Ryan ruthryan at COX.NET
Fri Nov 20 17:17:37 UTC 2015


I can't speak to the rigor of the research method in the study.

But people tend to make the same mistakes, fall into the same pitfalls.

I think identifying pitfalls helps people be more aware and fall in less.
Certainly more specificity would help.

Ruth



-----Original Message-----
From: Robert L Wears, MD, MS, PhD [mailto:wears at ufl.edu] 
Sent: Friday, November 20, 2015 10:31 AM
To: Ruth Ryan <ruthryan at COX.NET>; IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Diagnostic errors related to acute abdominal pain
in the emergency department.

These sorts of reports are so contaminated by hindsight and outcome biases
that they cannot possibily advance our field.  

Seeing deficiencies in hindsight is does not  explaination the generation,
persistence, or rationalisation of those deficiencies.  Standing in the
rubble, it is easy to marvel at how misguided people were, but that doesn't
answer the question of why none of these deficiencies struck people as
deficiencies at the time.

bob


On 19 Nov 2015 at 16:34, Ruth Ryan wrote:

> I can't get to the whole article, but here is a link to the abstract.
> http://www.ncbi.nlm.nih.gov/pubmed/26531859
> 
> 
> 
> Medford-Davis L, Park E, Shlamovitz G, Suliburk J, Meyer AN, Singh H.
> Diagnostic errors related to acute abdominal pain in the emergency 
> department.
> 
> Emerg Med J. 2015 Nov 3. pii: emermed-2015-204754. doi:
> 10.1136/emermed-2015-204754. [Epub ahead of print]
> 
> 
> 
> Of interest, over 1/3 of high risk abdominal pain pts in the ED in 
> this study had diagnostic errors. The most commonly missed diagnoses 
> were gall bladder disease and UTI, confirming once again that it tends 
> to be the most common diagnoses, not the rarest that are misdiagnosed.
> 
> 
> 
> 2/3 of the cases had breakdowns in the diagnostic process, most often
> 
> *        history-taking
> 
> *        ordering insufficient tests
> 
> *        problems with follow-up of abnormal test results
> 
> 
> 
> Ruth
> 
> 
> 
> Ruth Ryan RN, BSN, MSW, CPHRM
> 
> Medical writer
> 
> Risk management/patient safety
> 
> Continuing medical education
> 
> Telephone (504) 256-8797
> 
> Email ruthryan at cox.net <mailto:ruthryan at cox.net>
> 
> 
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> 
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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
All my means are sane, my motives and object mad.
                                          --Ahab






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