Errors

• How various types of bias can lead to diagnostic errors
• To avoid these biases
• Re-assess DDx as new data becomes available
• Do not ignore or discount data that contradicts your DDx
• Do not blindly accept a diagnosis from another provider without assessing the patient yourself
  
• Re-assess DDx if therapeutic plan is not improving patient's clinical condition
  
• Re-assess patient and revist the H&P
  

Anchoring Bias

• Sticking too heavily to first piece of data or initial impression
• ""
  

Confirmation Bias

• Ignoring or discounting data that contradicts initial impression and focusing only on data that supports initial impression
• ""
  

Premature Closure

• Finding a diagnosis that fits the clinical situation and then suspending further consideration of a broader DDx
  
• "This patient had a known history of GERD so their abdominal pain fits a diagnosis of a gastric ulcer"
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Diagnostic Momentum

• Diagnosis presented by one physician is accepted by the next without reassessing the DDx
• "Mr. Smith's family doctor sent him in to the ED to be treated for pneumonia"
• What if his cough and SOB are due to CHF, ACS, or Dsxn?
• "The paramedics said this guy is a drunk who was passed out at the train station"
• What if he wasn't passed out or drunk but seized or syncopized or had a CNS injury?