Reducing cognitive errors in dermatology: can anything be done?
Cognition; cognitive science; Dermatology/*standards; diagnostic errors; Diagnostic Errors/classification/*prevention & control; differential diagnosis; Humans; patient safety; quality assurance
An increasing focus on the prevention of medical errors is a direct result of a growing patient safety movement. Although the reduction of technical errors has been the focus of most interventions, cognitive errors, usually more than one error linked together, actually cause the majority of misdiagnoses. This article examines the most common types of cognitive errors in dermatology. Two methods to minimize these errors are recommended: first, cognitive debiasing techniques reduce the common initiating factor of error cascades; and secondly, the application of prospective hindsight attacks the final common pathway that leads to misdiagnosis.
Dunbar Miles; Helms Stephen E; Brodell Robert T
Journal of the American Academy of Dermatology
2013
2013-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2013.07.008" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2013.07.008</a>
Angular cheilitis, part 2: nutritional, systemic, and drug-related causes and treatment.
Humans; Cheilitis/diagnosis/*etiology/*therapy; Drug Eruptions/complications; Malnutrition/complications
Angular cheilitis (AC) is associated with a variety of nutritional, systemic, and drug-related factors that may act exclusively or in combination with local factors. Establishing the underlying etiology of AC is required to appropriately focus treatment efforts.
Park Kelly K; Brodell Robert T; Helms Stephen E
Cutis
2011
2011-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Angular cheilitis, part 1: local etiologies.
Humans; Risk Factors; Cheilitis/*etiology/microbiology; Infection/complications; Dermatitis; Allergic Contact/complications
Angular cheilitis (AC) is a common condition characterized by erythema, moist maceration, ulceration, and crusting at the corners of the mouth. This article focuses on the common local factors that act alone and in combination to produce AC. These factors are categorized as irritant, allergic, and infectious causes. Identifying the underlying etiology of AC is a critical step in developing an effective treatment plan for this condition.
Park Kelly K; Brodell Robert T; Helms Stephen E
Cutis
2011
2011-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
The CARE approach to reducing diagnostic errors.
*Checklist; 80 and over; Aged; Allergic Contact/*diagnosis/therapy; Bias; Communication; Dermatitis; Dermatology/*methods; Diagnosis; Diagnostic Errors/*prevention & control; Differential; Female; Humans; Patient Care Planning
BACKGROUND: Diagnostic errors appear to be the most common, costly, and dangerous of all medical mistakes. There has been a notable increase on the focus of error prevention as part of a growing patient safety movement. However, diagnostic errors have received less attention than other types of error. Our goal is to present a short mnemonic that can act as a checklist or posted reminder to help practitioners in dermatology or any field of medicine to avoid diagnostic errors. METHODS: To meet this goal, the authors reviewed the literature and discussed errors and potential errors they have experienced over 55 years of combined practice, to create a short mnemonic. RESULTS: The CARE method has helped the authors prepare and review their differential diagnoses in the relatively fast-paced practice of dermatology, but it has yet to be tested on a large scale. CONCLUSION: The CARE (communicate, assess for biased reasoning, reconsider differential diagnoses, enact a plan) method is an efficient, recallable checklist that uses an educational approach to reduce diagnostic error while reminding us to simply "care" from a humanistic perspective. This method may help reduce preventable diagnostic errors and improve patient care.
Rush Jess L; Helms Stephen E; Mostow Eliot N
International journal of dermatology
2017
2017-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/ijd.13532" target="_blank" rel="noreferrer noopener">10.1111/ijd.13532</a>