SUNY Health Science Center at Brooklyn, Brooklyn, New York; Kings County Hospital Center, Brooklyn, New York; South Nassau Dermatology PC, Oceanside and Long Beach, New York.
SUNY Health Science Center at Brooklyn, Brooklyn, New York; Staten Island University Hospital/Northwell Health, Staten Island, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
J Am Acad Dermatol. 2019 Dec;81(6):1237-1245. doi: 10.1016/j.jaad.2018.12.072. Epub 2019 Feb 21.
Diagnostic error in dermatology is a large practice gap that has received little attention. Diagnosis in dermatology relies heavily on a heuristic approach that is responsible for our perception of clinical findings. To improve our diagnostic accuracy, a better understanding of the strengths and limitations of heuristics (cognitive shortcuts) used in dermatology is essential. Numerous methods have been proposed to improve diagnostic accuracy, including brain training, reducing cognitive load, and getting feedback and second opinions. Becoming comfortable with the uncertainty intrinsic to medicine is essential. Ultimately, the practice of metacognition, or thinking about how we think, can offer corrective insights to improve accuracy in diagnosis.
皮肤科的诊断错误是一个很大的实践差距，但一直未受到关注。皮肤科的诊断很大程度上依赖于启发式方法，这是我们对临床发现的感知的基础。为了提高我们的诊断准确性，我们必须更好地理解启发式方法（认知捷径）在皮肤科中的优势和局限性。已经提出了许多方法来提高诊断准确性，包括大脑训练、降低认知负荷以及获取反馈和第二意见。熟悉医学固有的不确定性至关重要。最终，元认知实践，即思考我们的思维方式，可以提供纠正性的见解，以提高诊断的准确性。
