Authorship: Mark L Graber, MD FACP
Society to Improve Diagnosis in Medicine
Diagnosis is perhaps the most complicated cognitive task humans face. Despite the many challenges involved, the correct diagnosis is established in the great majority of cases, thanks in very large part to advances in medical testing, such as mass spectrometry. At the same time, diagnostic errors are too common and cause enormous harm. The origins of diagnostic errors will be explored, providing insights that can improve not only diagnosis, but the decisions we make in our everyday lives and research enterprises.
Diagnosis in medicine is possibly the most difficult cognitive task that humans face. There are more than 10,000 diseases and 5000 diagnostic tests, and uncertainty is the norm at every step of the diagnostic process. In view of these challenges it is remarkable that the correct diagnosis is achieved in the great majority of cases. From a long-term perspective, the success of diagnosis has advanced almost entirely from advances in diagnostic testing, such as mass spectrometry and related tools. It is very likely that future improvements in diagnosis will also derive from new technologies and advances, yet to be conceived, in the measurement sciences.
Despite the remarkable achievements that have been realized, diagnosis is too often flawed, resulting in diagnostic errors and harm. According to current estimates, almost everyone will experience one or more diagnostic errors in their lifetime, and there are currently 40,000 to 80,000 deaths per year as a result of diagnostic error. Because diagnosis is so complex, the causes of errors are complex, and involve inherent flaws in our healthcare delivery systems, as well as breakdowns in the cognitive steps that make up the clinical reasoning process. Understanding these errors is the first step in trying to address them. Exploring the cognitive origins of diagnostic error provides lessons that are highly relevant to the decisions we make in our every day lives, and research and development programs.
References & Acknowledgements:
Improving Diagnosis in Healthcare http://nas.edu/improvingdiagnosis
|Grants||yes||AHRQ, VA, NPSF|
|Expenses||yes||Various academic medical centers, patient safety organizations, and health insurers|
IP Royalty: yes
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