Evidence map›Paper›PMID 40916928›Full record

ArticleJournal of evaluation in clinical practice2025

A Reflective Verbalization Strategy to Trigger Alternative Diagnostic Hypotheses.

Sho Isoda, Taro Shimizu, Tadayuki Hashimoto, Fumio Shimada, Miwa Misawa, Tomio Suzuki

Abstract read
In one paragraph

Article in Journal of evaluation in clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Sho IsodaDepartment of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Osaka, Japan.ORCID 0000-0002-2163-4841
Taro ShimizuJapan Diagnostic Excellence Team, Japan.
Tadayuki HashimotoDepartment of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Osaka, Japan.
Fumio ShimadaDepartment of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Osaka, Japan.
Miwa MisawaDepartment of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Osaka, Japan.
Tomio SuzukiDepartment of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Osaka, Japan.

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

rationalePhysicians sometimes encounter various types of gut feelings (GFs) during clinical diagnosis. The type of GF addressed in this paper refers to the intuitive sense that the generated hypothesis might be incorrect. An appropriate diagnosis cannot be obtained unless these GFs are articulated and inventive solutions are devised. Thus, the method of articulating GFs is critical. AIMS AND

objectivesThe current study proposes reflective verbalization (RV) to help healthcare professionals capitalize on their GF. In cognitive psychology, RV is the process of verbalizing one's thoughts and feelings through metacognition, to promote deeper understanding and insight problem-solving. When applied to clinical reasoning, RV can help doctors verbalize their GFs, refining their diagnostic hypotheses.

methodTo address GFs systematically using RV, we introduce the DATES approach, comprising five perspectives: Degree, Abandoned, Time course, Excess, and Shortage. Each perspective prompts physicians to compare their patient's information against typical illness scripts, ensuring no detail is omitted or overlooked. RESULTS AND

conclusionThe tool also aids physicians in considering possible differential diagnoses for one or more of these elements. This guiding tool may aid physicians in overcoming biases, including confirmation and anchoring biases, thus improving diagnostic accuracy. This tool is useful for healthcare professionals who wish to improve their clinical reasoning and decision-making abilities, particularly when they encounter inexplicable contradictions in their diagnostic hypotheses.

Indexed as

Clinical Decision-MakingClinical ReasoningPhysiciansDiagnosis, DifferentialEmotionsHumansProblem Solvingcreativitydebiasingdiagnostic excellencegut feelinginsightreflective verbalization

Identifiers

PMID40916928
PMCPMC12415801

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