New Study of Dx Error in the Emergency Dept

DR WILLIAM CORCORAN williamcorcoran at SBCGLOBAL.NET
Thu Apr 21 13:12:44 UTC 2016


 
Look forward to the day when all data from a patient’smedical, occupational, locational, genetic, recreational, and family history isfed into a computer that already contains the integrated body of knowledge andthe computer will render a probabilistic diagnosis with error and confidenceand will suggest additional tests and other data to reduce the error andincrease the confidence.  


 
The computer could also suggest interventions and theircost-benefit predictions.


 
The physician’s added value would include supervising input dataquality, assessing computer output, engaging the patient, facilitatinginterventions, follow-up, etc.

 Take care,
 
Bill Corcoran

 
William  R. Corcoran, Ph.D., P.E.
21 Broadleaf Circle
Windsor, CT 06095-1634
860-285-8779
William.R.Corcoran at 1959.USNA.com
http://www.linkedin.com/in/williamcorcoranphdpehttps://www.box.com/shared/kfxg1lt9dh 

 

    On Thursday, April 21, 2016 7:46 AM, Jason Maude <jason.maude at ISABELHEALTHCARE.COM> wrote:
 
 

 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.
RegardsJason
Jason MaudeFounder and CEO Isabel Healthcare


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

#yiv6478614680 #yiv6478614680 -- _filtered #yiv6478614680 {panose-1:2 4 5 3 5 4 6 3 2 4;} _filtered #yiv6478614680 {font-family:Calibri;panose-1:2 15 5 2 2 2 4 3 2 4;} _filtered #yiv6478614680 {panose-1:3 1 1 1 1 1 1 1 1 1;} _filtered #yiv6478614680 {panose-1:3 15 7 2 3 3 2 2 2 4;}#yiv6478614680 #yiv6478614680 p.yiv6478614680MsoNormal, #yiv6478614680 li.yiv6478614680MsoNormal, #yiv6478614680 div.yiv6478614680MsoNormal {margin:0in;margin-bottom:.0001pt;font-size:12.0pt;}#yiv6478614680 a:link, #yiv6478614680 span.yiv6478614680MsoHyperlink {color:blue;text-decoration:underline;}#yiv6478614680 a:visited, #yiv6478614680 span.yiv6478614680MsoHyperlinkFollowed {color:purple;text-decoration:underline;}#yiv6478614680 span.yiv6478614680EmailStyle17 {color:#1F497D;}#yiv6478614680 .yiv6478614680MsoChpDefault {} _filtered #yiv6478614680 {margin:1.0in 1.0in 1.0in 1.0in;}#yiv6478614680 div.yiv6478614680WordSection1 {}#yiv6478614680 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.   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 Emailruthryan at cox.net         

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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

  

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