A perfect storm averted: flawed systems, a dropped ball, and cognitive biases delay a critical diagnosis.

Thomas J Roberts; Maclean C Sellars; Jacob M Sands; Joseph Jacobson

Commentary

A perfect storm averted: flawed systems, a dropped ball, and cognitive biases delay a critical diagnosis.

November 2, 2022

Roberts TJ, Sellars MC, Sands JM, et al. JCO Oncol Pract. 2022;18(12):833-839.

View more articles from the same authors.

Missed diagnosis of infectious diseases can have serious consequences for patient safety. This article describes a delayed diagnosis of disseminated tuberculosis in a patient with lung cancer and discusses the how cognitive biases and systems failures contributed to the diagnostic error.

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A perfect storm averted: flawed systems, a dropped ball, and cognitive biases delay a critical diagnosis.

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