Evidence map›Paper›PMID 38066602›Full record

ArticleBMC medical education2023

Insights into diagnostic errors in endocrinology: a prospective, case-based, international study.

Jessica Frey, Leah T Braun, Laura Handgriff, Benjamin Kendziora, Martin R Fischer, Martin Reincke, Laura Zwaan, Ralf Schmidmaier

Abstract readMulticenter Study
In one paragraph

Article in BMC medical education, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jessica FreyMedizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University Munich, Ziemssenstr. 5, 80336, Munich, Germany.
Leah T BraunMedizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University Munich, Ziemssenstr. 5, 80336, Munich, Germany. Leah.Braun@med.uni-muenchen.de.
Laura HandgriffMedizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University Munich, Ziemssenstr. 5, 80336, Munich, Germany.
Benjamin KendzioraDepartment of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany.
Martin R FischerInstitute of Medical Education, University Hospital, LMU Munich, Munich, Germany.
Martin ReinckeMedizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University Munich, Ziemssenstr. 5, 80336, Munich, Germany.
Laura ZwaanErasmus MC iMERR (Institute of Medical Education Research Rotterdam), Rotterdam, Netherlands.
Ralf SchmidmaierMedizinische Klinik und Poliklinik IV, University Hospital, Ludwig-Maximilians-University Munich, Ziemssenstr. 5, 80336, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiagnostic errors in internal medicine are common. While cognitive errors have previously been identified to be the most common contributor to errors, very little is known about errors in specific fields of internal medicine such as endocrinology. This prospective, multicenter study focused on better understanding the causes of diagnostic errors made by general practitioners and internal specialists in the area of endocrinology.

methodsFrom August 2019 until January 2020, 24 physicians completed five endocrine cases on an online platform that simulated the diagnostic process. After each case, the participants had to state and explain why they chose their assumed diagnosis. The data gathering process as well as the participants' explanations were quantitatively and qualitatively analyzed to determine the causes of the errors. The diagnostic processes in correctly and incorrectly solved cases were compared.

resultsSeven different causes of diagnostic error were identified, the most frequent being misidentification (mistaking one diagnosis with a related one or with more frequent and similar diseases) in 23% of the cases. Other causes were faulty context generation (21%) and premature closure (17%). The diagnostic confidence did not differ between correctly and incorrectly solved cases (median 8 out of 10, p = 0.24). However, in incorrectly solved cases, physicians spent less time on the technical findings (such as lab results, imaging) (median 250 s versus 199 s, p < 0.049).

conclusionsThe causes for errors in endocrine case scenarios are similar to the causes in other fields of internal medicine. Spending more time on technical findings might prevent misdiagnoses in everyday clinical practice.

Indexed as

EndocrinologyGeneral PractitionersDiagnostic ErrorsHumansInternal MedicineProspective StudiesClinical reasoningDiagnostic errorsEndocrinologyInternal medicine

Identifiers

PMID38066602
PMCPMC10709946

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.