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Search results for "United States of America"

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Meeting/Conference > Canada Meeting/Conference

Preventing Overdiagnosis.

The Quebec Medical Association, Dartmouth Institute, British Medical Journal,Wiser Healthcare, Centre for Evidence-Based Medicine, and Consumer Reports. August 17-19 2017, Québec City Convention Centre, Quebec City.

Overdiagnosis has emerged as a quality and safety concern due to its potential to result in harm for patients and their families. This conference will explore methods to define overdiagnosis, why it occurs, and strategies to reduce its incidence.

Meeting/Conference > District of Columbia Meeting/Conference

Improving Diagnosis in Health Care: An Implementation Workshop.

The National Academies of Sciences, Engineering, and Medicine. July 17, 2017; National Academy of Sciences Building, Washington, DC.

Diagnostic error gained recognition as a patient safety concern with the publication of the Improving Diagnosis in Health Care report in 2015. This workshop will discuss progress since the report's release and review strategies for building on those successes to reduce diagnostic error.

Journal Article > Commentary

Challenges and opportunities from the Agency for Healthcare Research and Quality (AHRQ) research summit on improving diagnosis: a proceedings review.

Henriksen K, Dymek C, Harrison MI, Brady JP, Arnold SB. Diagnosis. 2017 May 23; [Epub ahead of print].

Diagnostic error gained recognition as a patient safety concern with the publication of the Improving Diagnosis in Health Care report. This commentary reviews insights shared at a conference convened to discuss issues associated with diagnosis, including the need for concrete definitions of diagnostic error, the role of technology in improvement, and organizational factors that contribute to the problem.

Newspaper/Magazine Article

The last person you'd expect to die in childbirth.

Martin N, Montagne R. ProPublica and National Public Radio. May 12, 2017.

Maternal mortality is increasing in the United States. This news article reports on this critical safety problem in the context of the preventable death of a patient whose diagnosis of preeclampsia was missed by her providers, despite persistent concerns raised by family about the patient's symptoms.

Journal Article > Commentary

Farewell to a cancer that never was.

Lyon J. JAMA. 2017;317:1824-1825.

Overdiagnosis can result in financial, psychological, and physical harm for patients. This commentary discusses the reclassification of a subtype of thyroid cancer as a nonmalignancy and the impact changing guidelines can have on patients.

Journal Article > Study

Characteristics associated with requests by pathologists for second opinions on breast biopsies.

Geller BM, Nelson HD, Weaver DL, et al. J Clin Pathol. 2017 May 2; [Epub ahead of print].

Second opinions can shed light on challenging diagnoses. This observational cross-sectional study identified several clinical factors that prompted pathologists to seek second opinions for breast biopsies, including breast density, cellular atypia, and complex patients with multiple coexisting diagnoses. The authors suggest that such characteristics could prompt a second opinion in order to enhance diagnostic accuracy.

Journal Article > Commentary

An innovative collaborative model of care for undiagnosed complex medical conditions.

Nageswaran S, Donoghue N, Mitchell A, Givner LB. Pediatrics. 2017;139:e20163373.

Lack of collaboration among the clinical team can contribute to diagnostic problems. This commentary describes a collaborative model of care developed to enhance interdisciplinary teamwork across health care settings as a strategy to augment diagnosis for children with undiagnosed complex medical conditions.

Newspaper/Magazine Article

Deep learning is a black box, but health care won't mind.

Brouillette M. MIT Technol Rev. April 27, 2017.

Artificial intelligence can support diagnostic decision-making. This magazine article reports on the use of algorithms to identify dermatologic cancers and highlights progress toward achieving success with these tools.

Journal Article > Commentary

Identifying and analyzing diagnostic paths: a new approach for studying diagnostic practices.

Rao G, Epner P, Bauer V, Solomonides A, Newman-Toker DE. Diagnosis. 2017;4:67-72.

This commentary explores diagnosis of common conditions in primary care and highlights approaches for studying the process, such as practice variation and patterning. The authors suggest big data as a method to mine electronic medical records to identify the information needed to inform improvement.

Newspaper/Magazine Article

The opioid crisis: can improving diagnosis help solve the problem?

Carr S. ImproveDx. April 2017;4:1-4.

The opioid epidemic has been widely discussed, but little research has examined how misdiagnosis can contribute to the problem. This newsletter article suggests that addressing bias, improving diagnosis, and providing pain management training for primary care providers could augment opioid safety.

Journal Article > Study

Extent of diagnostic agreement among medical referrals.

Van Such M, Lohr R, Beckman T, Naessens JM. J Eval Clin Pract. 2017 Apr 4; [Epub ahead of print].

Diagnostic uncertainty is common and can lead to missed or delayed diagnoses. This retrospective medical record review study examined cases where primary care providers sought diagnostic input from subspecialists. Investigators compared the final diagnosis from the subspecialty visit with the presumed diagnosis at the time of the initial subspecialty referral. They found that the diagnosis differed substantially in about one-fifth of cases following the subspecialty consultation. Costs were higher for cases with substantively different diagnoses compared to cases where subspecialists confirmed or further clarified diagnoses. The authors conclude that subspecialty access is critical to timely and accurate diagnosis. A recent WebM&M commentary discussed how cognition can influence diagnostic decision making.

Journal Article > Study

Pathologists' perspectives on disclosing harmful pathology error.

Dintzis SM, Clennon EK, Prouty CD, Reich LM, Elmore JG, Gallagher TH. Arch Pathol Lab Med. 2017;141:841-845.

Disclosure of medical errors is a recommended patient safety practice. This focus group study of pathologists found that most pathologists believe treating clinicians should disclose pathology errors and express concern that treating clinicians do not understand the inherent limitations of pathologic diagnosis. The authors suggest that developing consensus guidelines may improve disclosure of pathology errors.

Journal Article > Study

Rates and characteristics of paid malpractice claims among US physicians by specialty, 1992–2014.

Schaffer AC, Jena AB, Seabury SA, Singh H, Chalasani V, Kachalia A. JAMA Intern Med. 2017;177:710-718.

This retrospective study of a claims database found that medical malpractice claims declined significantly between 1992 and 2014, but mean payment amounts increased at the same time. Diagnostic error was the overall most common reason for a claim, affirming the importance of improving diagnosis.

Journal Article > Commentary

Overcoming diagnostic errors in medical practice.

Bordini BJ, Stephany A, Kliegman R. J Pediatr. 2017 Mar 20; [Epub ahead of print].

This commentary describes a program developed to evaluate patients with undiagnosed and rare diseases as a way to reduce diagnostic error. The authors explain heuristic and clinical reasoning shortcomings that can hinder diagnosis and how to manage them through improved information gathering and hypothesis testing.

Audiovisual

The War on Error: Common Diagnostic Errors.

Medscape. 2016–2017.

Improving diagnosis has recently been recognized as a primary focus for patient safety. This collection highlights particular clinical areas of concern such as neurology and infectious disease. The articles offer expert commentary and review strategies to avoid common reasoning errors.

Journal Article > Commentary

A learning health care system using computer-aided diagnosis.

Cahan A, Cimino JJ. J Med Internet Res. 2017;19:e54.

Although advanced computing can assist in diagnosis, these systems are not routinely utilized. This commentary suggests a framework to develop diagnostic support technologies that capture physician knowledge to enhance diagnostic safety. The authors encourage drawing from crowdsourced data to guide improvements at a system level to address future practice and educational needs.

Audiovisual > Audiovisual Presentation

Diagnosis as a team sport.

Armstrong Center for Diagnostic Excellence. March 1, 2017; 1:00–2:00 PM (Eastern).

Teamwork is an important strategy to reduce diagnostic error. This webinar will outline barriers to effective collaboration and highlight the value of a multidisciplinary approach to preventing diagnostic error. Dr. David Newman-Toker is the featured speaker.

Journal Article > Commentary

The CARE approach to reducing diagnostic errors.

Rush JL, Helms SE, Mostow EN. Int J Dermatol. 2017;56:669-673.

Cognitive aids such as checklists and mnemonics can improve process reliability. This project report discusses the development of a mnemonic focused on avoiding diagnostic errors. The authors used the CARE mnemonic (communicate, assess for biased reasoning, reconsider differential diagnoses, enact a plan) as an instruction model to reduce diagnostic errors in their practice.

Journal Article > Study

Primary care collaboration to improve diagnosis and screening for colorectal cancer.

Schiff GD, Bearden T, Hunt LS, et al. Jt Comm J Qual Patient Saf. 2017;43:338–350.

Delayed diagnosis of colon cancer due to missed screening or follow-up leads to preventable morbidity and mortality. In this quality improvement effort, the study team sought to enhance colon cancer screening in primary care. They identified several important drivers of successful screening programs, including leadership support, patient engagement, teamwork, tracking of results, closed loops for referrals, and health information technology tools to support best practices. Sequential plan-do-study-act cycles were implemented to improve processes. Participating practices had widely varying baseline screening rates, and some sites demonstrated significant improvements from baseline while others did not change. The effort required to augment colon cancer screening in primary care demonstrates the challenge of implementing evidence-based practices in order to achieve timely diagnosis of cancer.

Newspaper/Magazine Article

Bias in the ER. Doctors suffer from the same cognitive distortions as the rest of us.

Lewis M. Nautilus. February 9, 2017.

Physicians' decision-making can be diminished when they are tired, distracted, or too narrowly task-focused. This article discusses cognitive biases and other limitations that affect physicians' ability to process information effectively and explores how these factors can contribute to uncertainty and clinical misjudgment.

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