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dc.contributor.authorMinué, Sergio
dc.contributor.authorBermúdez-Tamayo, Clara
dc.contributor.authorFernández Ajuria, Alberto
dc.contributor.authorMartín-Martín, José Jesús
dc.contributor.authorBenítez Hidalgo, Vivian
dc.contributor.authorMelguizo, Miguel
dc.contributor.authorCaro Martínez, Araceli
dc.contributor.authorOrgaz, María José
dc.contributor.authorPrados, Miguel Ángel
dc.contributor.authorDíaz, José Enrique
dc.contributor.authorMontoro, Rafael
dc.date.accessioned2014-06-12T07:57:10Z
dc.date.available2014-06-12T07:57:10Z
dc.date.issued2014
dc.identifier.citationMinué, S.; et al. Identification of factors associated with diagnostic error in primary care. BMC Family Practice, 15: 92 (2014). [http://hdl.handle.net/10481/32228]es_ES
dc.identifier.issn1471-2296
dc.identifier.urihttp://hdl.handle.net/10481/32228
dc.description.abstractBackground Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason’s taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed.es_ES
dc.description.abstractMethods Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician’s initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians’ perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified.es_ES
dc.description.abstractDiscussion This work sets out a new approach to studying the diagnostic decision-making process in PC, taking advantage of new technologies which allow immediate recording of the decision-making process.es_ES
dc.description.sponsorshipThe authors gratefully acknowledge funding of this research from the Spanish Research Agency. Ministry of Health (Fondo de Investigaciones Sanitarias) FIS PI10/01468 and the European Regional Development Fund (ERDF).es_ES
dc.language.isoenges_ES
dc.publisherBiomed Centrales_ES
dc.subjectPrimary carees_ES
dc.subjectDiagnostic errorses_ES
dc.subjectDecision-makinges_ES
dc.titleIdentification of factors associated with diagnostic error in primary carees_ES
dc.typejournal articlees_ES
dc.rights.accessRightsopen accesses_ES
dc.identifier.doi10.1186/1471-2296-15-92


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