Insights into diagnostic errors in endocrinology: a prospective, case-based, international study
Abstract Background Diagnostic errors in internal medicine are common. While cognitive errors have previously been identified to be the most common contributor to errors, very little is known about errors in specific fields of internal medicine such as endocrinology. This prospective, multicenter st...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Medical Education |
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| Online Access: | https://doi.org/10.1186/s12909-023-04927-5 |
| _version_ | 1797397971261718528 |
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| author | Jessica Frey Leah T. Braun Laura Handgriff Benjamin Kendziora Martin R. Fischer Martin Reincke Laura Zwaan Ralf Schmidmaier |
| author_facet | Jessica Frey Leah T. Braun Laura Handgriff Benjamin Kendziora Martin R. Fischer Martin Reincke Laura Zwaan Ralf Schmidmaier |
| author_sort | Jessica Frey |
| collection | DOAJ |
| description | Abstract Background Diagnostic errors in internal medicine are common. While cognitive errors have previously been identified to be the most common contributor to errors, very little is known about errors in specific fields of internal medicine such as endocrinology. This prospective, multicenter study focused on better understanding the causes of diagnostic errors made by general practitioners and internal specialists in the area of endocrinology. Methods From August 2019 until January 2020, 24 physicians completed five endocrine cases on an online platform that simulated the diagnostic process. After each case, the participants had to state and explain why they chose their assumed diagnosis. The data gathering process as well as the participants’ explanations were quantitatively and qualitatively analyzed to determine the causes of the errors. The diagnostic processes in correctly and incorrectly solved cases were compared. Results Seven different causes of diagnostic error were identified, the most frequent being misidentification (mistaking one diagnosis with a related one or with more frequent and similar diseases) in 23% of the cases. Other causes were faulty context generation (21%) and premature closure (17%). The diagnostic confidence did not differ between correctly and incorrectly solved cases (median 8 out of 10, p = 0.24). However, in incorrectly solved cases, physicians spent less time on the technical findings (such as lab results, imaging) (median 250 s versus 199 s, p < 0.049). Conclusions The causes for errors in endocrine case scenarios are similar to the causes in other fields of internal medicine. Spending more time on technical findings might prevent misdiagnoses in everyday clinical practice. |
| first_indexed | 2024-03-09T01:17:58Z |
| format | Article |
| id | doaj.art-cb482d59b9784d2eafccd8f2ee097a72 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-03-09T01:17:58Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-cb482d59b9784d2eafccd8f2ee097a722023-12-10T12:22:28ZengBMCBMC Medical Education1472-69202023-12-012311810.1186/s12909-023-04927-5Insights into diagnostic errors in endocrinology: a prospective, case-based, international studyJessica Frey0Leah T. Braun1Laura Handgriff2Benjamin Kendziora3Martin R. Fischer4Martin Reincke5Laura Zwaan6Ralf Schmidmaier7Medizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University MunichMedizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University MunichMedizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University MunichDepartment of Dermatology and Allergology, University Hospital, LMU MunichInstitute of Medical Education, University Hospital, LMU MunichMedizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University MunichErasmus MC iMERR (Institute of Medical Education Research Rotterdam)Medizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University MunichAbstract Background Diagnostic errors in internal medicine are common. While cognitive errors have previously been identified to be the most common contributor to errors, very little is known about errors in specific fields of internal medicine such as endocrinology. This prospective, multicenter study focused on better understanding the causes of diagnostic errors made by general practitioners and internal specialists in the area of endocrinology. Methods From August 2019 until January 2020, 24 physicians completed five endocrine cases on an online platform that simulated the diagnostic process. After each case, the participants had to state and explain why they chose their assumed diagnosis. The data gathering process as well as the participants’ explanations were quantitatively and qualitatively analyzed to determine the causes of the errors. The diagnostic processes in correctly and incorrectly solved cases were compared. Results Seven different causes of diagnostic error were identified, the most frequent being misidentification (mistaking one diagnosis with a related one or with more frequent and similar diseases) in 23% of the cases. Other causes were faulty context generation (21%) and premature closure (17%). The diagnostic confidence did not differ between correctly and incorrectly solved cases (median 8 out of 10, p = 0.24). However, in incorrectly solved cases, physicians spent less time on the technical findings (such as lab results, imaging) (median 250 s versus 199 s, p < 0.049). Conclusions The causes for errors in endocrine case scenarios are similar to the causes in other fields of internal medicine. Spending more time on technical findings might prevent misdiagnoses in everyday clinical practice.https://doi.org/10.1186/s12909-023-04927-5Clinical reasoningDiagnostic errorsEndocrinologyInternal medicine |
| spellingShingle | Jessica Frey Leah T. Braun Laura Handgriff Benjamin Kendziora Martin R. Fischer Martin Reincke Laura Zwaan Ralf Schmidmaier Insights into diagnostic errors in endocrinology: a prospective, case-based, international study BMC Medical Education Clinical reasoning Diagnostic errors Endocrinology Internal medicine |
| title | Insights into diagnostic errors in endocrinology: a prospective, case-based, international study |
| title_full | Insights into diagnostic errors in endocrinology: a prospective, case-based, international study |
| title_fullStr | Insights into diagnostic errors in endocrinology: a prospective, case-based, international study |
| title_full_unstemmed | Insights into diagnostic errors in endocrinology: a prospective, case-based, international study |
| title_short | Insights into diagnostic errors in endocrinology: a prospective, case-based, international study |
| title_sort | insights into diagnostic errors in endocrinology a prospective case based international study |
| topic | Clinical reasoning Diagnostic errors Endocrinology Internal medicine |
| url | https://doi.org/10.1186/s12909-023-04927-5 |
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