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

Robert L Wears, MD, MS, PhD wears at UFL.EDU
Fri Nov 20 16:30:55 UTC 2015


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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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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