Diagnostic Errors Induced by a Wrong a Priori Diagnosis: A Prospective Randomized Simulator-Based Trial
| Autor: | Mark G Filipovic, Kai Tisljar, Timur Sellmann, Stephan Marsch, Felix M L Meyer, Gianmarco M. Balestra |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Patient Encounter
Pediatrics medicine.medical_specialty pulmonary embolism lcsh:Medicine Presumptive diagnosis Diagnostic accuracy diagnostic error Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Clinical endpoint Medicine 030212 general & internal medicine Myocardial infarction business.industry 030503 health policy & services lcsh:R General Medicine medicine.disease simulation humanities Pulmonary embolism myocardial infarction Cohort randomized controlled trial 0305 other medical science business |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 4 Journal of Clinical Medicine, Vol 10, Iss 826, p 826 (2021) |
| ISSN: | 2077-0383 |
| Popis: | Preventive strategies against diagnostic errors require the knowledge of underlying mechanisms. We examined the effects of a wrong a priori diagnosis on diagnostic accuracy of a focussed assessment in an acute myocardial infarction scenario. One-hundred-and-fifty-six medical students (cohort 1) were randomized to three study arms differing in the a priori diagnosis revealed: no diagnosis (control group), myocardial infarction (correct diagnosis group), and pulmonary embolism (wrong diagnosis group). Forty-four physicians (cohort 2) were randomized to the control group and the wrong diagnosis group. Primary endpoint was the participants’ final presumptive diagnosis. Among students, the correct diagnosis of an acute myocardial infarction was made by 48/52 (92%) in the control group, 49/52 (94%) in the correct diagnosis group, and 14/52 (27%) in the wrong diagnosis group (p < 0.001 vs. both other groups). Among physicians, the correct diagnosis was made by 20/21 (95%) in the control group and 15/23 (65%) in the wrong diagnosis group (p = 0.023). In the wrong diagnosis group, 31/52 (60%) students and 6/23 (19%) physicians indicated their initially given wrong a priori diagnosis pulmonary embolism as final diagnosis. A wrong a priori diagnosis significantly increases the likelihood of a diagnostic error during a subsequent patient encounter. |
| Databáze: | OpenAIRE |
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