dc.contributor.author
Hautz, Stefanie C.
dc.contributor.author
Schuler, Luca
dc.contributor.author
Kämmer, Juliane E.
dc.contributor.author
Schauber, Stefan K.
dc.contributor.author
Ricklin, Meret E.
dc.contributor.author
Sauter, Thomas C.
dc.contributor.author
Maier, Volker
dc.contributor.author
Birrenbach, Tanja
dc.contributor.author
Exadaktylos, Aristomenis
dc.contributor.author
Hautz, Wolf E.
dc.date.accessioned
2018-06-08T03:53:29Z
dc.date.available
2016-08-12T11:07:04.190Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/16155
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-20339
dc.description.abstract
Introduction Emergency rooms (ERs) generally assign a preliminary diagnosis to
patients, who are then hospitalised and may subsequently experience a change
in their lead diagnosis (cDx). In ERs, the cDx rate varies from around 15% to
more than 50%. Among the most frequent reasons for diagnostic errors are
cognitive slips, which mostly result from faulty data synthesis. Furthermore,
physicians have been repeatedly found to be poor self-assessors and to be
overconfident in the quality of their diagnosis, which limits their ability to
improve. Therefore, some of the clinically most relevant research questions
concern how diagnostic decisions are made, what determines their quality and
what can be done to improve them. Research that addresses these questions is,
however, still rare. In particular, field studies that allow for generalising
findings from controlled experimental settings are lacking. The ER, with its
high throughput and its many simultaneous visits, is perfectly suited for the
study of factors contributing to diagnostic error. With this study, we aim to
identify factors that allow prediction of an ER's diagnostic performance.
Knowledge of these factors as well as of their relative importance allows for
the development of organisational, medical and educational strategies to
improve the diagnostic performance of ERs. Methods and analysis We will
conduct a field study by collecting diagnostic decision data, physician
confidence and a number of influencing factors in a real-world setting to
model real-world diagnostic decisions and investigate the adequacy, validity
and informativeness of physician confidence in these decisions. We will
specifically collect data on patient, physician and encounter factors as
predictors of the dependent variables. Statistical methods will include
analysis of variance and a linear mixed-effects model. Ethics and
dissemination The Bern ethics committee approved the study under KEK Number
197/15. Results will be published in peer-reviewed scientific medical
journals. Authorship will be determined according to ICMJE guidelines. Trial
registration number The study protocol Version 1.0 from 17 May 2015 is
registered in the Inselspital Research Database Information System (IRDIS) and
with the IRB (‘Kantonale Ethikkomission’) Bern under KEK Number 197/15.
en
dc.rights.uri
http://creativecommons.org/licenses/by-nc/4.0/
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit
dc.title
Factors predicting a change in diagnosis in patients hospitalised through the
emergency room
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
BMJ Open. - 6 (2016), Artikel Nr.e011585
dc.title.subtitle
a prospective observational study
dcterms.bibliographicCitation.doi
10.1136/bmjopen-2016-011585
dcterms.bibliographicCitation.url
http://bmjopen.bmj.com/content/6/5/e011585
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000025071
refubium.note.author
Der Artikel wurde in einer Open-Access-Zeitschrift publiziert.
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000006817
dcterms.accessRights.openaire
open access