Cognitive Process of Diagnostic Error in Emergency Physicians (diagnosis)

Diagnostic error, Dual process model of reasoning) During the last decade, much emphasis has been placed on system solutions to patient safety problems. However, diagnostic error, despite being responsible for twice as many adverse events as medication error, has received little attention. The rate of diagnostic errors have been estimated to be between 0.6% to 12%.Some estimates are as high as 15%.The rate of negative outcome or adverse effects of diagnostic errors range from 6.9% to 17%. Most authors accept that the dual process model of reasoning explains how clinicians make diagnoses. The purpose of this study is to investigate why diagnostic errors occurred in the emergency departments (EDs).

Study Overview

• Status: Completed
• Conditions: Thinking

Detailed Description

Diagnostic error, Dual process model of reasoning) During the last decade, much emphasis has been placed on system solutions to patient safety problems. However, diagnostic error, despite being responsible for twice as many adverse events as medication error, has received little attention. The rate of diagnostic errors have been estimated to be between 0.6% to 12%.Some estimates are as high as 15%.The rate of negative outcome or adverse effects of diagnostic errors range from 6.9% to 17%. Most authors accept that the dual process model of reasoning explains how clinicians make diagnoses. The purpose of this study is to investigate why diagnostic errors occurred in the emergency departments (EDs). A qualitative study approach was used with in-depth semi-structured interviews conducted with emergency physicians to investigate the cognitive diagnosis process. The study takes place in the EDs of three hospitals in Taiwan. We chose the participants using a purposive sampling technique to yield a sample that would be most likely contribute significant information on the diagnostic process. Sampling continued until novel information was no longer being gathered. All audiotapes were transcribed verbatim. The transcripts are analyzed by two of the investigators based on the ground theory. Once all relevant codes were identified, they were grouped together into meaningful categories. These categories were then grouped under appropriate themes, which were used to generate a theory of diagnostic errors.

• Study Type: Observational
• Enrollment (Actual): 30

Contacts and Locations

Study Locations

• Taiwan
  • Taipei, Taiwan, 10630
    • Cathay hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

emergency physicians

Description

Inclusion Criteria:

• trained emergency physicians

Exclusion Criteria:

• refused interview

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
interview; emergency physicians

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
generate a theory of diagnostic errors	Dec., 2015

Collaborators and Investigators

• Sponsor: Cathay General Hospital
• Collaborators: Cardinal Tien Hospital
• Investigators: Principal Investigator: Chaou-Shune Lin, MD, Hsinchu Cathay General Hospital

Study record dates

Study Major Dates

• Study Start: May 1, 2014
• Primary Completion (ACTUAL): November 1, 2015
• Study Completion (ACTUAL): November 1, 2015

Study Registration Dates

• First Submitted: May 27, 2014
• First Submitted That Met QC Criteria: July 22, 2019
• First Posted (ACTUAL): July 24, 2019

Study Record Updates

• Last Update Posted (ACTUAL): July 24, 2019
• Last Update Submitted That Met QC Criteria: July 22, 2019
• Last Verified: July 1, 2019

More Information

Terms related to this study

• Keywords: diagnostic error
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: CGH-P103018 (OTHER: CGH)