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Mamede S, de Carvalho-Filho MA, de Faria RMD, et al. BMJ Qual Saf. 2020;29:550-559.
There is uncertainty about the effectiveness of cognitive debiasing in reducing bias that can contribute to diagnostic error. Instead of focusing on the process of reasoning, this study examined whether an intervention directed at refining knowledge of a cluster of related disease can ‘immunize’ physicians against bias. Ninety-one internal medicine residents in Brazil were randomized to one of two sets of vignettes (reflecting diseases associated with either chronic diarrhea or jaundice) and compared/contrasted alternative diagnoses. After residents encountered one case of a disease, non-immunized residents twice as likely to give that incorrect diagnosis to a different (but similar) disease, resulting in a 40% decrease in diagnostic accuracy between immunized and non-immunized physicians.
Barbanti-Brodano G, Griffoni C, Halme J, et al. Eur Spine J. 2019.
Checklists are one tool for improving communication and reducing risk of adverse outcomes. The World Health Organization Surgical Safety Checklist has been previously studied in various surgical specialties; this study sought to determine its effectiveness in spinal surgeries. The authors conducted a retrospective analysis comparing the incidence of complications pre-checklist and post-checklist in a single center and found a significant reduction in the overall incidence of complications after the introduction of the checklist.
Lermontov SP, Brasil SC, de Carvalho MR. Cancer Nurs. 2019;42:365-372.
Bone marrow transplantation requires complex drug therapy management. This systematic review identified 11 studies reporting both medication prescription and administration errors, as well as issues such illegible writing, polypharmacy, absence of medication reconciliation, and lack of patient education. These errors resulted in a variety of adverse events.  The review identified several prevention measures that can be implemented at the provider-level or systems-level (e.g., computerized prescribing systems).
de Araújo BC, de Melo RC, de Bortoli MC, et al. Front Pharmacol. 2019;10:439.
Prescribing errors are common and can result in patient harm. This review summarizes four key options to reduce prescribing errors: prescriber education, effective use of computerized alert systems at the clinical interface, use of tools and guidance to inform practice, and multidisciplinary teams that include pharmacists.
Tschandl P, Codella N, Akay BN, et al. Lancet Oncol. 2019;20:938-947.
Machine learning may have the potential to improve clinical decision-making and diagnosis. In this study, machine-learning algorithms generally performed better than human experts in accurately diagnosing 7 types of pigmented skin lesions and the top 3 algorithms performed better than the 27 physicians.
Silva M das DG, Martins MAP, Viana L de G, et al. Br J Clin Pharmacol. 2018;84:2252-2259.
This study, conducted at a Brazilian hospital, found that the IHI Global Trigger Tool had relatively poor accuracy at identifying adverse drug events among hospitalized patients. The accuracy and reliability of trigger tools have been questioned in other studies.
Carlotti APCP, Bachette LG, Carmona F, et al. Am J Clin Pathol. 2016;146:701-708.
This autopsy study demonstrated significant discrepancies between clinical and postmortem diagnoses among children who died in the intensive care unit. These results demonstrate the importance of autopsy as an educational tool for clinical teams to improve patient outcomes.