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急诊医疗中的误诊和漏诊:原因和同理心作为解决方案。

Misdiagnosis and failure to diagnose in emergency care: Causes and empathy as a solution.

机构信息

Center for Training and Research in Health Sciences Education (CFRPS), University of Strasbourg, 67085 Strasbourg, France; Prehospital Emergency Care Service (SAMU 67), Strasbourg University Hospital, France.

Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA.

出版信息

Patient Educ Couns. 2020 Aug;103(8):1650-1656. doi: 10.1016/j.pec.2020.02.039. Epub 2020 Feb 28.

Abstract

Diagnostic error is the most frequent cause of allegations of negligence in emergency care in the United States and is estimated to contribute to the death of hundreds of thousands of patients worldwide each year. In this special contribution, we elucidate the cognitive mechanisms that emergency physicians use to make decisions and identify how these mechanisms can become sources of diagnostic error. The discussion centers on the appraisal of proposed methods to reduce the risk of diagnostic error, including debiasing strategies and a brief discussion of the theoretical basis for interventions to improve clinician empathy.

摘要

诊断错误是美国急诊护理中指控疏忽的最常见原因,据估计,每年全球有数十万名患者因此死亡。在这篇特别贡献中,我们阐明了急诊医生用于做出决策的认知机制,并确定了这些机制如何成为诊断错误的来源。讨论集中在评估降低诊断错误风险的拟议方法上,包括去偏策略,并简要讨论了改善临床医生同理心的干预措施的理论基础。

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