New Study of Dx Error in the Emergency Dept

Thomas Benzoni benzonit at GMAIL.COM
Thu Apr 21 12:31:22 UTC 2016


Toss in the third alternative.
Patient has a self-healing disease but is treated anyway with a therapy for another disease.
Is this an error?
If so, how do we capture this statistic?

I am suspicious this may be an even larger pile than missed-needing-treatment.

Tom Benzoni 

Sent from my iPad

On Apr 21, 2016, at 2:51, Robert Bell <0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG> wrote:

> Tincture of time is often used to "treat" a patient who we have little or no idea about what is going on. How often in those cases is the diagnosis nothing of import? How often is it something missed? I suspect we do not know the answer. Any guesses?
> 
> RB
> 
> Sent from my iPad
> 
> On Apr 19, 2016, at 18:48, Mark Gusack <gusackm at COMCAST.NET> wrote:
> 
>> 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
>> 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
>> 
>>  
>> 
>> On Tue, Apr 19, 2016 at 2:19 PM, Ruth Ryan <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.
>> 
>>  
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>> 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
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>> Telephone (504) 256-8797
>> 
>> Email ruthryan at cox.net
>> 
>> <image001.jpg>
>> 
>>  
>> 
>>  
>> 
>>  
>> 
>> 
>> 
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> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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