Structured re-analysis of case findings may help improve diagnostic accuracy

September 14, 2010

Silvia Mamede, M.D., Ph.D., of Erasmus University Rotterdam, the Netherlands and colleagues investigated whether recent experience with clinical problems provokes availability bias (overestimation of the likelihood of a diagnosis based on the ease with which it comes to mind) resulting in diagnostic errors and whether reflection (structured reanalysis of the case findings) counteracts this bias.

The researchers conducted a study in 2009 with 18 first-year and 18 second-year internal medicine residents and found that "the availability bias may occur in medical diagnosis as a consequence of recent experiences with similar cases under nonanalytical reasoning conditions and that susceptibility to this effect may be related to having more clinical experience. It provided further evidence that flaws in reasoning processes rather than knowledge gaps may underlie diagnostic errors and showed the potential for repair by reflective reasoning."
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(JAMA. 2010;304[11]:1198-1203. Available pre-embargo to the media at www.jamamedia.org)

To contact Silvia Mamede, M.D., Ph.D., email mamede@fsw.eur.nl.

The JAMA Network Journals

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