Format

Send to

Choose Destination
Eur J Intern Med. 2013 Sep;24(6):525-9. doi: 10.1016/j.ejim.2013.03.006. Epub 2013 Apr 6.

Cognitive diagnostic error in internal medicine.

Author information

1
Erasmus Medical Center, Department of Internal Medicine, Rotterdam, the Netherlands. c.vandenberge@erasmusmc.nl

Abstract

Medical error poses an important healthcare burden and a challenge for physicians and policy makers worldwide. Diagnostic error accounts for a substantial fraction of all medical mistakes. Most diagnostic errors have been associated with flaws in clinical reasoning. Empirical evidence on the cognitive mechanisms underlying such flaws and effectiveness of strategies to counteract them is scarce. Recent experimental studies, reviewed in this article, have increased our understanding of the relationship between cognitive factors and diagnostic mistakes. These studies have explored the role of cognitive biases, such as confirmation and availability bias, in diagnostic mistakes. They have suggested that confirmation bias and availability bias may indeed cause diagnostic errors. The latter bias seems to be associated with non-analytical reasoning, and was neutralized by analytical, or reflective, reasoning. Although non-analytical reasoning is a hallmark of clinical expertise, reflective reasoning was shown to improve diagnoses when cases are complex. Research on cognitive diagnostic mistakes remains a quite novel line of investigation. Follow-up studies that shine more light on the cognitive roots of, and cure for, diagnostic errors are needed.

KEYWORDS:

Analytical reasoning; Clinical reasoning; Cognitive diagnostic error; Decision-making; Diagnostic error; Non-analytical reasoning

Comment in

PMID:
23566942
DOI:
10.1016/j.ejim.2013.03.006
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center