More Insight Into Diagnostic Mistakes On The Internal Medicine Service

medical_errors   Diagnostic mistakes in internal medicine are common, and this study probably underestimates them.  Researchers, many of them residents, in Toronto tracked diagnoses made on medicine inpatients by the ER physician, the admitting resident, and the admitting attending.  The “real” diagnosis was determined by chart review; the admitting attending’s diagnosis was accepted if no contrary information was found.  Attendings were more accurate than residents (79% vs. 66%), but this may reflect the study methodology and the fact that more information may have accumulated between the resident’s and the attending’s evaluations.  Attendings were very influenced by the residents’ diagnosis.  When the resident was correct, attendings were correct in 96% of cases; but if the resident was incorrect, the attending made the correct diagnosis in only 44% of cases. — Laura Willett, MD

Link to Article

Michael D. Jain, George A. Tomlinson, Danica Lam, Jessica Liu, Deepti Damaraju, Allan S. Detsky, and Luke A. Devine (2014) Workplace-Based Assessment of Internal Medicine Resident Diagnostic Accuracy. Journal of Graduate Medical Education: September 2014, Vol. 6, No. 3, pp. 532-535.
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