New Study of Dx Error in the Emergency Dept

Jason Maude jason.maude at ISABELHEALTHCARE.COM
Thu Apr 21 11:40:16 UTC 2016


Computers are actually very good at reminding clinicians of diseases with atypical presentations as they carry around in their ‘memory’ many more presentations than possible in the human memory coupled with instant recall 24/7.

Regards
Jason

Jason Maude
Founder and CEO Isabel Healthcare


From: Mark Gusack <gusackm at COMCAST.NET<mailto:gusackm at COMCAST.NET>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, Mark Gusack <gusackm at COMCAST.NET<mailto:gusackm at COMCAST.NET>>
Date: Wednesday, 20 April 2016 02:48
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: Re: [IMPROVEDX] New Study of Dx Error in the Emergency Dept

Good Evening Peggy:

I agree.  In fact, isn’t it our job as physicians to be on the lookout for ‘atypical’ presentations of diseases?  After all, if it weren’t for these ‘atypical’ presentations then diagnostic criteria would be so easy to apply that an eighth grader could do it.  In fact, a computer could do it…

Hoping to see you at the LA DEM conference.  I plan to submit a number of new posters that may be of interest to you.

Mark Gusack

From: Peggy Zuckerman [mailto:peggyzuckerman at GMAIL.COM]
Sent: Tuesday, April 19, 2016 5:57 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] New Study of Dx Error in the Emergency Dept

Surprises me to see that 'atypical' presentations are thought to be non-remedial.  Why not expand the definition of what is typical, though rarer?

The same kind of thinking that does not permit the 'atypical' presentation to be reviewed properly is where the "classic symptoms" are missing.  Example; in renal cell carcinoma, the 'classic' symptoms are present in fewer than 10% of cases.

Peggy Z

Peggy Zuckerman
www.peggyRCC.com<http://www.peggyRCC.com>

On Tue, Apr 19, 2016 at 2:19 PM, Ruth Ryan <ruthryan at cox.net<mailto:ruthryan at cox.net>> wrote:
A new study by our own peeps.

This is an ED study of 214 diagnostic errors involving most often the most common diagnoses (sepsis, MI, fractures, vascular events) related to the usual suspects of cognitive error and systems problems like high workload. Three quarters involved multiple factors.

Nearly a third were due to patient factors, and a similar number to “atypical” presentations (when will we find a better term for something that happens so often?).

Citation is: Okafor N, Payne VL, Singh H et al. Using voluntary reports from physicians to learn from diagnostic errors in emergency medicine.  Emerg Med J. 2016 Apr;33(4):245-52. doi: 10.1136/emermed-2014-204604. Epub 2015 Nov 3.

Link is: http://www.ncbi.nlm.nih.gov/pubmed/?term=Using+voluntary+reports+from+physicians+to+learn+from+diagnostic+errors+in+emergency+medicine


Ruth

Ruth Ryan RN, BSN, MSW, CPHRM
Medical writer
Risk management/patient safety
Continuing medical education
Telephone (504) 256-8797<tel:%28504%29%20256-8797>
Email ruthryan at cox.net<mailto:ruthryan at cox.net>
[canstockphoto14944494_revised]



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