神经眼科学中的诊断错误：改进途径。
Diagnostic Error in Neuro-ophthalmology: Avenues to Improve.
机构信息
Saint Louis University School of Medicine, St. Louis, MO, USA.
John F. Hardesty, MD Department of Ophthalmology and Visual Sciences and Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8096, St. Louis, MO, 63110, USA.
出版信息
Curr Neurol Neurosci Rep. 2022 Apr;22(4):243-256. doi: 10.1007/s11910-022-01189-4. Epub 2022 Mar 23.
PURPOSE OF REVIEW
To highlight potential avenues to reduce preventable diagnostic error of neuro-ophthalmic conditions and avoid patient harm.
RECENT FINDINGS
Recent prospective studies and studies of patient harm have advanced our understanding. Additionally, recent studies of fundus photography, telemedicine, and artificial intelligence highlight potential avenues for diagnostic improvement. Diagnostic error of neuro-ophthalmic conditions can often be traced to failure to gather an adequate history, perform a complete physical exam, obtain adequate/appropriate neuroimaging, and generate a complete, appropriate differential diagnosis. Improving triage and identification of neuro-ophthalmic conditions by other providers and increasing access to subspecialty neuro-ophthalmology evaluation are essential avenues to reduce diagnostic error. Further research should evaluate the relationship between misdiagnosis and patient harm, and help identify the most impactful potential targets for improvement.
目的综述
强调减少神经眼科疾病可预防的诊断错误并避免患者伤害的潜在途径。
最近的发现
最近的前瞻性研究和对患者伤害的研究加深了我们的理解。此外，眼底摄影、远程医疗和人工智能的最新研究强调了诊断改进的潜在途径。神经眼科疾病的诊断错误通常可以追溯到未能充分采集病史、进行全面的身体检查、获得充分/适当的神经影像学检查以及生成完整、适当的鉴别诊断。通过其他医疗服务提供者改善分诊和神经眼科疾病的识别，并增加获得神经眼科专科评估的机会，是减少诊断错误的重要途径。进一步的研究应该评估误诊与患者伤害之间的关系，并帮助确定最有影响力的潜在改进目标。
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