From: Diagnostic errors by medical students: results of a prospective qualitative study
Type | Definition [5] | Example |
---|---|---|
Knowledge base inadequate | Insufficient knowledge of relevant condition | “Poor general and nutritional condition with fever. Positive (blood) culture with acid-resistant rods. Unfortunately, I can’t remember which pathogen this kind of staining indicates.” (diagnosed: infection, correct diagnosis: tuberculosis) |
Skills inadequate | Insufficient diagnostic skills for relevant condition | “….no hint for pneumothorax or pneumonia” (diagnosed: viral infection, correct diagnosis: pneumothorax) |
Faulty context generation | Lack of awareness of relevant aspects of the case | “patient has dyspnea and inflammatory markers” (diagnosed: viral infection, correct diagnosis: COPD) |
Overestimating/ underestimating | Focus too closely on an aspect or failure to appreciate the relevance | “He also has a renal insufficiency – this might explain the nausea. But the atrial fibrillation explains the dyspnea” (diagnosed: atrial fibrillation, correct diagnosis: uremia) |
Faulty triggering | Inappropriate conclusion | “Infection of the upper airways, pericardial effusion” (diagnosed: viral airway infection, correct diagnosis: myocarditis) |
Misidentification | One diagnosis is mistaken for another | “… post-streptococcal endocarditis. History of infection and ST-segment elevation in the electrocardiogram” (diagnosed: endocarditis, correct diagnosis: myocarditis) |
Premature closure | Failure to consider other possible diagnosis | “the risk factors, the acute onset of symptoms and the young age of the patient are indicative for a pulmonary embolism” (diagnosed: pulmonary embolism, correct diagnosis: hyperventilation) |
Cluelessness | Failure to find any diagnosis at all | “based on the given information I could not find a diagnosis, it could be an iron deficiency anemia but this would not explain the acute onset (….)” (diagnosis missing, correct diagnosis: AV-node-reentry-tachycardia) |