Every Patient Tells A Story Part 13

Chapter 9: Sick Thinking.

197 Diagnostic errors are the second leading cause: Diagnostic errors are the second leading cause: Bartlett EE. Physicians' cognitive errors and their liability consequences. Bartlett EE. Physicians' cognitive errors and their liability consequences. J Healthcare Risk Manage J Healthcare Risk Manage. 1998(fall):6269.

197 And a recent study of autopsy findings: And a recent study of autopsy findings: Tai DYH, El-Bilbeisi H, Tewari S, Mascha EJ, Wiedermann HP, Arroliga AC. A study of consecutive autopsies in a medical ICU: a comparison of clinical cause of death and autopsy diagnosis. Tai DYH, El-Bilbeisi H, Tewari S, Mascha EJ, Wiedermann HP, Arroliga AC. A study of consecutive autopsies in a medical ICU: a comparison of clinical cause of death and autopsy diagnosis. Chest Chest. 2001;119:530536.

198 One survey showed that over one third of patients: One survey showed that over one third of patients: Berner ES, et al. Overconfidence as a cause of diagnostic error in medicine. Berner ES, et al. Overconfidence as a cause of diagnostic error in medicine. Am J Med Am J Med. 2008;121(5A):S2S23.

200 Faulty synthesis ... by comparison, played a role: Faulty synthesis ... by comparison, played a role: Errors of inadequate data collection are probably underrepresented in this sample because it was based on chart review. If something was missed, it won't be in the chart. To pick up this kind of error requires access to the patient at the time of the diagnosis. Errors of inadequate data collection are probably underrepresented in this sample because it was based on chart review. If something was missed, it won't be in the chart. To pick up this kind of error requires access to the patient at the time of the diagnosis.

201 "Thinking stops when a diagnosis is made": "Thinking stops when a diagnosis is made": Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med Acad Med. 2003;78(8):16.

201 "process of matching": "process of matching": Croskerry P. Overconfidence in clinical decision making. Croskerry P. Overconfidence in clinical decision making. Am J Med Am J Med. 2008;121(5A):S24S29.

201 "the power of thin slicing": "the power of thin slicing": Gladwell M. Gladwell M. Blink Blink. NY: Little, Brown, 2005. http://www.gladwell.com/blink/.

203 "The trick lies in matching": "The trick lies in matching": Croskerry P. The theory and practice of clinical decision-making. Croskerry P. The theory and practice of clinical decision-making. Can J Anesth Can J Anesth. 2005;52(6):R1R8.

206 black men are significantly more likely: black men are significantly more likely: http://www.cdc.gov/cancer/prostate/statistics/race.htm, accessed May 1, 2008.

207 "despite their 'objective' medical training": "despite their 'objective' medical training": McKinlay JB, Potter DA, Feldman HA. Non-medical influences on medical decision-making. McKinlay JB, Potter DA, Feldman HA. Non-medical influences on medical decision-making. Soc Sci Med Soc Sci Med. 1996;42(5):769776.

207 And even those factors: And even those factors: Ibid. Ibid.

207 One of the many careful experiments: One of the many careful experiments: Arber S, McKinlay J, Adams A, Marceau L, Link C, O'Donnell A. Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: a video-simulation experiment. Arber S, McKinlay J, Adams A, Marceau L, Link C, O'Donnell A. Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: a video-simulation experiment. Soc Sci Med Soc Sci Med. 2006;62(1):103115. 214 In the 1930s: In the 1930s: Gawande A. "The Checklist." Gawande A. "The Checklist." The New Yorker The New Yorker, 12/10/07, http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande.

214 These basic steps: These basic steps: Wachter RE. Wachter RE. Understanding Patient Safety Understanding Patient Safety. New York: McGraw-Hill Medical, 2008, p. 23.

215 surgical safety checklist: surgical safety checklist: Haynes AB et al. A surgical safety checklist to reduce morbidity and mortality in a global population. Haynes AB et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med N Engl J Med. 2009; 360, pp. 491499.

215 checklist before certain procedures in the ICU: checklist before certain procedures in the ICU: p.r.o.novost Petal. An intervention to decrease catheter-related bloodstream infections in the ICU. p.r.o.novost Petal. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med N Engl J Med. 2006;355, pp. 27252732.

Chapter 10: Digital Diagnosis.

216 In a 1976 article, a group of doctors: In a 1976 article, a group of doctors: Pauker SG, Gorry GA, Ka.s.sirer J P, Schwartz WB. Towards the simulation of clinical cognition taking a present illness by computer. Pauker SG, Gorry GA, Ka.s.sirer J P, Schwartz WB. Towards the simulation of clinical cognition taking a present illness by computer. Am J Med Am J Med. 1976;60:981996.

221 In 1994 she and a group of thirteen other physicians: In 1994 she and a group of thirteen other physicians: Berner ES, Webster GD, Shugerman AA, et al. Performance of four computer-based diagnostic systems. Berner ES, Webster GD, Shugerman AA, et al. Performance of four computer-based diagnostic systems. N Engl J Med N Engl J Med. 1994;330:17921796.

229 In order to measure how well the program can perform: In order to measure how well the program can perform: Leonhardt D. Why doctors so often get it wrong. Leonhardt D. Why doctors so often get it wrong. New York Times New York Times, February 22, 2006.

229 Mark Graber and a colleague: Mark Graber and a colleague: Graber MI, Matthew A. Performance of a web-based clinical diagnosis support system for internists. Graber MI, Matthew A. Performance of a web-based clinical diagnosis support system for internists. J Gen Int Med J Gen Int Med. 2008;23(supp 1):3740.

231 According to a 2005 survey done by the Pew Center: According to a 2005 survey done by the Pew Center: Boone S. Computer users can catch the health bug on line. Boone S. Computer users can catch the health bug on line. McClatchy-Tribune Regional NewsThe Walton Sun McClatchy-Tribune Regional NewsThe Walton Sun, November 17, 2007.

234 Finally, the visiting professor asked the fellow: Finally, the visiting professor asked the fellow: Greenwald R.... And a diagnostic test was performed. Greenwald R.... And a diagnostic test was performed. N Engl J Med N Engl J Med (letter). 2005;353:20892090. (letter). 2005;353:20892090.

235 This story and their own experiences with patients: This story and their own experiences with patients: Tang H, Hwee Kwoon Ng J. Googling for a diagnosis-use of Google as a diagnostic aid: Internet based study. Tang H, Hwee Kwoon Ng J. Googling for a diagnosis-use of Google as a diagnostic aid: Internet based study. BMJ BMJ. 2006;333;11431145.

236 Even the august Even the august New England Journal of Medicine New England Journal of Medicine: Fan E et al. A gut feeling. Fan E et al. A gut feeling. N Eng J Med N Eng J Med. 2008;359:7580.

Afterword: The Final Diagnosis 241 Medicine's first toehold: Medicine's first toehold: Much of this comes from Roy Porter's wonderful history of medicine, Much of this comes from Roy Porter's wonderful history of medicine, The Greatest Benefit to Mankind The Greatest Benefit to Mankind. NY: Norton, 1999; as well as from Jacalyn Duffin's biography of Rene Laennee, To See with a Better Eye To See with a Better Eye. Princeton, NJ: Princeton University Press, 1998.

232 These days, patients who die in a hospital: These days, patients who die in a hospital: David Dobb wrote a terrific piece about autopsy, "Buried Answers," for the David Dobb wrote a terrific piece about autopsy, "Buried Answers," for the New York Times Magazine New York Times Magazine, April 24, 2005.

243 Small residency programs objected to the ever growing cost: Small residency programs objected to the ever growing cost: From Accreditation Council for Graduate Medical Education, a private nonprofit council that evaluates and accredits medical residency programs in the United States, personal communication. From Accreditation Council for Graduate Medical Education, a private nonprofit council that evaluates and accredits medical residency programs in the United States, personal communication.

243 Certainly a doctor's ability to make an accurate diagnosis: Certainly a doctor's ability to make an accurate diagnosis: A report from the Agency for Healthcare Research and Quality, written by Was.h.i.+ngton AE and McDonald KM, The autopsy as an outcome and performance measure (Evidence Report/Technology a.s.sessment 58, October 2002), provided much of the information on the modern history of the autopsy. A report from the Agency for Healthcare Research and Quality, written by Was.h.i.+ngton AE and McDonald KM, The autopsy as an outcome and performance measure (Evidence Report/Technology a.s.sessment 58, October 2002), provided much of the information on the modern history of the autopsy.