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BACKGROUND Diagnostic error in primary care can have serious implications for the patient, the clinician and the health-care system, possibly more so than other types of error. OBJECTIVE To identify common characteristics of diseases that GPs may misdiagnose. METHODS Systematic search of the MEDLINE and EMBASE databases for primary research on(More)
Physicians often encounter diagnostic problems with ambiguous and conflicting features. What are they likely to do in such situations? We presented a diagnostic scenario to 84 family physicians and traced their information gathering, diagnoses and management. The scenario contained an ambiguous feature, while the other features supported either a cardiac or(More)
BACKGROUND Anecdotal evidence suggests variation in intubation decisions for chronic obstructive pulmonary disease (COPD) patients with respiratory failure, but little is known about the extent of or reasons for this variability. AIM To describe clinician decision-making for patients with exacerbations of COPD considered for intubation. DESIGN Telephone(More)
OBJECTIVE To investigate the role of information gathering and clinical experience on the diagnosis and management of difficult diagnostic problems in family medicine. METHOD Seven diagnostic scenarios including 1 to 4 predetermined features of difficulty were constructed and presented on a computer to 84 physicians: 21 residents in family medicine, 21(More)
BACKGROUND Designers of computerised diagnostic support systems (CDSSs) expect physicians to notice when they need advice and enter into the CDSS all information that they have gathered about the patient. The poor use of CDSSs and the tendency not to follow advice once a leading diagnosis emerges would question this expectation. AIM To determine whether(More)
Neonatal intensive care involves continuous monitoring of highly unstable patients in order to plan and deliver effective care and treatment. Making care and treatment decisions depends upon using information obtained in many different ways. Analysis of care and treatment tasks shows how much staff need to rely on one another for crucial information. This(More)
OBJECTIVE To classify events of actual or potential harm to primary care patients using a multilevel taxonomy of cognitive and system factors. METHODS Observational study of patient safety events obtained via a confidential but not anonymous reporting system. Reports were followed up with interviews where necessary. Events were analysed for their causes(More)
UNLABELLED The Learning Health System (LHS) describes linking routine healthcare systems directly with both research translation and knowledge translation as an extension of the evidence-based medicine paradigm, taking advantage of the ubiquitous use of electronic health record (EHR) systems. TRANSFoRm is an EU FP7 project that seeks to develop an(More)
PURPOSE Delays in diagnosing celiac disease average 13 years. We aimed to identify reasons for misdiagnosis in family medicine. BACKGROUND During a larger study on diagnosis, a scenario describing a 30-year-old female with 3-month abdominal pain, diarrhea, and microcytic anemia consistent with celiac disease was presented on a computer to 84 family(More)
Participants decided whom of two patients to prioritize for surgery in three studies. The factual quantitative information about the patients (e.g., probability of surviving surgery) was given in vignette form with case descriptions on Visual Analogue Scales — VAS's. Differentiation and Consolidation theory predicts that not only the attractiveness of facts(More)