How Often are you unsure of Diagnoses?

Bruno, Michael mbruno at PENNSTATEHEALTH.PSU.EDU
Sat Jun 29 20:55:15 UTC 2019


Yes, highlighting the observation that, in high-reliability systems, everyone remembers to be afraid.



It also reminds me of Sir. Wm. Osler's characterization of physicians into two distinct categories (i.e., "there are only two kinds of doctors in the world...")

(1) the overconfident, and

(2) the under-confident!

;)



MAB





________________________________
From: David Ryon <0000001375a3a914-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>
Sent: Saturday, June 29, 2019 10:48 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] How Often are you unsure of Diagnoses?

Because of self-reporting, I’m suspect that it’s a stretch to draw any conclusion. Recall the Dunning-Kruger effect: those least suspicious of diagnostic uncertainty might in fact be great contributors to error. And vice versa, those most nervous about diagnosis might in fact be doing OK.

David Ryon

Sent from my iPhone

On Jun 28, 2019, at 9:50 AM, Jason Maude <jason.maude at isabelhealthcare.com<mailto:jason.maude at isabelhealthcare.com>> wrote:

This survey has now got 463 respondents so the results are looking more credible. Do you think there is a close correlation between these 2 questions?


  *   How often do you experience diagnostic uncertainty while practicing medicine?

Every day                      47%
About once a week       19%
Several times a month  16%



  *   How often do you think you make diagnostic errors?

Every day                       15%
About once a week        21%
Several times a month   17%

For me there is a disconnect between clinicians often saying they don’t have time or need to use decision support tools and the frequency of them facing dx uncertainly and subsequent errors as shown by this survey. The numbers imply that 2/3 of the time when there is dx uncertainty it turns into an error.

Regards
Jason

From: JASON MAUDE <jason.maude at ISABELHEALTHCARE.COM<mailto:jason.maude at ISABELHEALTHCARE.COM>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, JASON MAUDE <jason.maude at isabelhealthcare.com<mailto:jason.maude at isabelhealthcare.com>>
Date: Wednesday, 26 June 2019 at 22:29
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [IMPROVEDX] How Often are you unsure of Diagnoses?

This is a fascinating article and survey on Medscape. So far 85% of clinicians say they experience diagnostic uncertainty several times a month or more. Please respond to the survey and pass around to your colleagues so we can get see the results with a significant response rate.
https://www.medscape.com/viewarticle/914892<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.medscape.com_viewarticle_914892&d=DwMFaQ&c=_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0&r=XZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ&m=0xOvCju6QJ_x9dI2-hvWHx1g3pyoLPElcvkxfPAHWWs&s=V9eb2zY5OK-m2mrHHKXO3-gXQaSMhCjpM39XJogfQGA&e=>

Regards
Jason

Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890
www.isabelhealthcare.com<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.isabelhealthcare.com_&d=DwMFaQ&c=_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0&r=XZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ&m=0xOvCju6QJ_x9dI2-hvWHx1g3pyoLPElcvkxfPAHWWs&s=trJgaUGHob1vJ4LIFM9Xdy8tJaObTHWvySeJRqipVaE&e=>

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On Friday, June 28, 2019, Jason Maude <jason.maude at ISABELHEALTHCARE.COM> wrote:


This survey has now got 463 respondents so the results are looking more credible. Do you think there is a close correlation between these 2 questions?



  *   How often do you experience diagnostic uncertainty while practicing medicine?



Every day                      47%

About once a week       19%

Several times a month  16%



  *   How often do you think you make diagnostic errors?



Every day                       15%

About once a week        21%

Several times a month   17%



For me there is a disconnect between clinicians often saying they don’t have time or need to use decision support tools and the frequency of them facing dx uncertainly and subsequent errors as shown by this survey. The numbers imply that 2/3 of the time when there is dx uncertainty it turns into an error.



Regards

Jason



From: JASON MAUDE <jason.maude at ISABELHEALTHCARE.COM>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, JASON MAUDE <jason.maude at isabelhealthcare.com>
Date: Wednesday, 26 June 2019 at 22:29
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] How Often are you unsure of Diagnoses?



This is a fascinating article and survey on Medscape. So far 85% of clinicians say they experience diagnostic uncertainty several times a month or more. Please respond to the survey and pass around to your colleagues so we can get see the results with a significant response rate.

https://www.medscape.com/viewarticle/914892<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.medscape.com_viewarticle_914892&d=DwQFaQ&c=_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0&r=XZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ&m=0xOvCju6QJ_x9dI2-hvWHx1g3pyoLPElcvkxfPAHWWs&s=V9eb2zY5OK-m2mrHHKXO3-gXQaSMhCjpM39XJogfQGA&e=>



Regards

Jason



Jason Maude

Founder and CEO Isabel Healthcare

Tel: +44 1428 644886

Tel: +1 703 879 1890

www.isabelhealthcare.com<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.isabelhealthcare.com&d=DwQFaQ&c=_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0&r=XZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ&m=0xOvCju6QJ_x9dI2-hvWHx1g3pyoLPElcvkxfPAHWWs&s=921N0Uax-QuduZuJENitr5vEC2VCJSsBAYWDqrA30-s&e=>



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


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