literature pertaining to cognitive bias in the evaluation of trauma patients

Hoar III MD, Harry Harry.HoarIIIMD at BAYSTATEHEALTH.ORG
Wed Apr 24 16:46:17 UTC 2019


I agree that Croskerry’s work may be the most helpful.

I would particularly recommend his 2002 paper from Academic Emergency Medicine Achieving Quality in Clinical Decision Making: Cognitive Strategies and Detection of Bias. There is an extensive table describing a multitude of cognitive biases, the biases that may be most relevant to your needs are:  search satisficing, Sutton’s slip, and vertical line failure.   https://www.ncbi.nlm.nih.gov/pubmed/12414468

Also suggest a 2007 article by Campbell, Croskerry, and Bond in Academic Emergency Medicine Profiles in Patient Safety: A “Perfect Storm” in the Emergency Department.  This article discusses the importance of context and labelling (i.e., as a “trauma patient” in your case) as well as reasons why additional diagnoses may not have been considered in the case (although not a trauma case, the same principles would seem to apply).
https://www.ncbi.nlm.nih.gov/pubmed/?term=Profiles+in+Patient+Safety%3A+A+%E2%80%9CPerfect+Storm%E2%80%9D+in+the+Emergency+Department.

Harry


From: Albert Wu [mailto:awu at JHU.EDU]
Sent: Wednesday, April 24, 2019 8:44 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] literature pertaining to cognitive bias in the evaluation of trauma patients

⚠ EXTERNAL EMAIL
Read Pat Croskerry’s work including his book

Diagnosis: interpreting the shadows

Best regards
Albert Wu

From: Lisa Cuttle <l.cuttle at GMAIL.COM>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, Lisa Cuttle <l.cuttle at GMAIL.COM>
Date: Tuesday, April 23, 2019 at 11:53 PM
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] literature pertaining to cognitive bias in the evaluation of trauma patients

Hi all,

Long-time reader, first time poster- I am an ED physician and I will be giving a lecture for a trauma symposium (audience primarily EMS, nursing, and some residents). I plan to talk about cognitive bias in the evaluation of the trauma patient (for example, missing a diagnosis like STEMI or stroke that led to the MVC or fall because of the focus on the injuries themselves). I have a number of good case examples, but was looking for any literature that might be available. My searches have not turned up much thus far. If anyone knows of anything pertinent I would be grateful. Thanks much in advance,

Lisa

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