Cognitive interventions to reduce diagnostic error: a narrative review

@article{Graber2012CognitiveIT,
  title={Cognitive interventions to reduce diagnostic error: a narrative review},
  author={Mark L Graber and Stephanie M Kissam and Velma L. Payne and Ashley N. D. Meyer and Asta V. Sorensen and Nancy F. Lenfestey and Elizabeth M. Tant and Kerm Henriksen and Kenneth A. Labresh and Hardeep Singh},
  journal={BMJ Quality \& Safety},
  year={2012},
  volume={21},
  pages={535 - 557}
}
Background Errors in clinical reasoning occur in most cases in which the diagnosis is missed, delayed or wrong. The goal of this review was to identify interventions that might reduce the likelihood of these cognitive errors. Design We searched PubMed and other medical and non-medical databases and identified additional literature through references from the initial data set and suggestions from subject matter experts. Articles were included if they either suggested a possible intervention or… 
Dual-process cognitive interventions to enhance diagnostic reasoning: a systematic review
TLDR
While many of the studies found some effect of interventions, guided reflection interventions emerged as the most consistently successful across five studies, and cognitive forcing strategies improved accuracy and confidence judgements.
Interventions targeted at reducing diagnostic error: systematic review
Background Incorrect, delayed and missed diagnoses can contribute to significant adverse health outcomes. Intervention options have proliferated in recent years necessitating an update to McDonald et
Interventions to improve diagnostic decision making: A systematic review and meta-analysis on reflective strategies
Abstract Aims: To identify, appraise and describe studies of cognitive interventions to improve diagnostic decision making (DDM) amongst medical professionals, assess their effectiveness and identify
Patient Safety Strategies Targeted at Diagnostic Errors
TLDR
Overall, the review showed a growing field of diagnostic error research and categorized and identified promising interventions that warrant evaluation in large studies across diverse settings.
Education initiatives in cognitive debiasing to improve diagnostic accuracy in student providers: A scoping review
TLDR
Guided reflection, the most clearly defined and implemented strategy, showed the most promise for improvement of diagnostic accuracy, while Educational interventions were wide ranging in content and delivery but did yield a path for future research.
Strategies to reduce diagnostic errors: a systematic review
TLDR
Limited evidence is revealed on interventions being practically used in clinical settings and a bias of studies originating from the US is revealed.
Diagnostic Errors: Impact of an Educational Intervention on Pediatric Primary Care.
  • Julianne Walsh, M. Knight, A. Lee
  • Medicine
    Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
  • 2018
Interventions to Mitigate Cognitive Biases in the Decision Making of Eye Care Professionals: A Systematic Review.
TLDR
A lack of studies investigating interventions intended to mitigate cognitive biases in the clinical decision making of eye care professionals indicates a critical need for research within the area of cognitive bias mitigation for decision making within eye care practice.
Guided Reflection Interventions Show No Effect on Diagnostic Accuracy in Medical Students
TLDR
This study finds no evidence to support the use of the guided reflection method as a diagnostic aid for novice diagnosticians, who may already use an analytical approach to diagnosis and therefore derive less benefit from this intervention than their more experienced colleagues.
Diagnostic Error in Pediatrics: A Narrative Review.
TLDR
This narrative review presents what is known about the incidence and epidemiology of diagnostic error in pediatrics as well as the established research methods for identifying, evaluating, and reducing diagnostic errors, including their strengths and weaknesses and proposes several key research questions aimed at addressing persistent gaps in the pediatric diagnostic error literature.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 211 REFERENCES
System-related interventions to reduce diagnostic errors: a narrative review
TLDR
Advancing the science of diagnostic error prevention will require more robust study designs and rigorous definitions of diagnostic processes and outcomes to measure intervention effects.
Effect of availability bias and reflective reasoning on diagnostic accuracy among internal medicine residents.
TLDR
When faced with cases similar to previous ones and using nonanalytic reasoning, second-year residents made errors consistent with the availability bias; subsequent application of diagnostic reflection tended to counter this bias and improved diagnostic accuracy in both first- and second- year residents.
The Effectiveness of Cognitive Forcing Strategies to Decrease Diagnostic Error: An Exploratory Study
TLDR
The first study to explore the impact of cognitive forcing strategy training on diagnostic error using consecutive enrollment of 56 senior medical students during their emergency medicine rotation suggests that application and retention is poor.
The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them
  • P. Croskerry
  • Psychology
    Academic medicine : journal of the Association of American Medical Colleges
  • 2003
TLDR
The author lists the major cognitive biases in medicine and describes a number of strategies for reducing them (“cognitive debiasing”), a reflective approach to problem solving that involves stepping back from the immediate problem to examine and reflect on the thinking process.
Cognitive forcing strategies in clinical decisionmaking.
TLDR
The adoption of this method provides a systematic approach to cognitive root-cause analysis in the avoidance of adverse outcomes associated with delayed or missed diagnoses and with the clinical management of specific cases.
Diagnostic difficulty and error in primary care--a systematic review.
TLDR
Misdiagnosis in primary care covers a wide range of conditions that may be related in the manner in which they present and the challenge is to identify ways of supporting the diagnostic process in potentially difficult presentations.
Clinical reasoning: the relative contribution of identification, interpretation and hypothesis errors to misdiagnosis
TLDR
It is concluded that the development of clinical reasoning in medical students throughout the course of their pre-clinical and clinical education may be enhanced by both an analysis of the clinical reasoning process and a specific focus on each of the stages at which errors commonly occur.
Learning clinical reasoning
TLDR
Clinicians must recognise the common errors in clinical reasoning and how to avoid them and teachers provide guidance on the cognitive processes involved in making diagnostic decisions.
Using SNAPPS to Facilitate the Expression of Clinical Reasoning and Uncertainties: A Randomized Comparison Group Trial
TLDR
Students in the SNAPPS group outperformed students in comparison and usual-and-customary groups for each outcome category and greatly facilitates and enhances expression of diagnostic reasoning and uncertainties during case presentations to ambulatory care preceptors.
Diagnostic errors and reflective practice in medicine.
TLDR
The nature of reflective practice in medicine is discussed, and whether and how the several behaviours and reasoning processes that constitute reflective practice could minimize diagnostic errors are explored.
...
1
2
3
4
5
...