Diagnostic Error associated with screening tests

Tommaso, Laura ltommaso at NCH.ORG
Thu Sep 14 17:24:38 UTC 2017


Screening tools should be a guide but should not override provider intuition.  I'd also ask the physician, what evidence did he have for fluid overload? Starting empiric antibiotics can cause harm, but starting diuretics in a pt with normal, or dry fluid status can cause more harm. Sometimes, it not about knowing the exact answer but following the past of least harm until you do know the answer. Besides the low pulse ox-the patient had no respiratory compromise, so there was really no need for emergent diuresis even if he was in FO. This is an excellent case from which to learn. Thanks for sharing and good luck with your submission!

From: robert bell [mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG]
Sent: Thursday, September 14, 2017 12:19 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Diagnostic Error associated with screening tests

Does that support the idea that it would be better to first deal with standard medical errors, or even concurrently, when considering diagnostic error planning and goals?

Is it worthwhile and sensible to focus just on diagnostic errors when we work in a big sea of other medical errors?

Rob Bell, M.D.
On Sep 13, 2017, at 5:56 PM, David Katz <d.katz at MAIL.UTORONTO.CA<mailto:d.katz at MAIL.UTORONTO.CA>> wrote:

Hi Group,

Some colleagues and myself submitted the following case to the AHRQ WebM&M series. It is a case of SIRS-negative sepsis in an elderly patient.
The discussion points focus on diagnostic error related to screening tests.
I thought it might be interesting to the group.
https://psnet.ahrq.gov/webmm/case/421/failed-interpretation-of-screening-tool-delayed-treatment

David Katz
M. Sc., M.D., FRCPC

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