(Of Possible Interest) We All Make Diagnostic Errors
sfranklin131 at GMAIL.COM
Tue Sep 3 22:19:37 UTC 2019
We All Make Diagnostic Errors
by Dan Mayer, M.D.
"Early in my second year of medical school, my class was given an assignment. We were told that a patient had come into the hospital with a slightly raised blotchy red rash (purpura) and kidney failure. Armed with the fictitious patient’s history, physical exam notes, and lab test results, I promptly went to the medical library and hand searched Index Medicus for papers on patients with this clinical picture. I finally diagnosed the patient with polyarteritis nodosa, an unusual autoimmune disorder.
I was quite proud of myself … until I presented my solution in class. There, I was told that not only was my diagnosis wrong, but that I had missed the most likely cause of the patient’s “palpable purpuric” rash: Henoch-Schonlein Purpura. In hindsight, I realized that I had fallen prey to a common cause of diagnostic error: I had dismissed the more likely diagnosis because the patient’s other symptoms did not quite fit the pattern for that illness."
(To read more about avoiding cognitive errors—follow link or Google name of article)
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