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Table 1 Error types and examples

From: Diagnostic errors by medical students: results of a prospective qualitative study

Type

Definition [5]

Example

Knowledge base inadequate

Insufficient knowledge of relevant condition

“Poor general and nutritional condition with fever. Positive (blood) culture with acid-resistant rods. Unfortunately, I can’t remember which pathogen this kind of staining indicates.”

(diagnosed: infection, correct diagnosis: tuberculosis)

Skills inadequate

Insufficient diagnostic skills for relevant condition

“….no hint for pneumothorax or pneumonia”

(diagnosed: viral infection, correct diagnosis: pneumothorax)

Faulty context generation

Lack of awareness of relevant aspects of the case

“patient has dyspnea and inflammatory markers”

(diagnosed: viral infection, correct diagnosis: COPD)

Overestimating/ underestimating

Focus too closely on an aspect or failure to appreciate the relevance

“He also has a renal insufficiency – this might explain the nausea. But the atrial fibrillation explains the dyspnea”

(diagnosed: atrial fibrillation, correct diagnosis: uremia)

Faulty triggering

Inappropriate conclusion

“Infection of the upper airways, pericardial effusion”

(diagnosed: viral airway infection, correct diagnosis: myocarditis)

Misidentification

One diagnosis is mistaken for another

“… post-streptococcal endocarditis. History of infection and ST-segment elevation in the electrocardiogram”

(diagnosed: endocarditis, correct diagnosis: myocarditis)

Premature closure

Failure to consider other possible diagnosis

“the risk factors, the acute onset of symptoms and the young age of the patient are indicative for a pulmonary embolism”

(diagnosed: pulmonary embolism, correct diagnosis: hyperventilation)

Cluelessness

Failure to find any diagnosis at all

“based on the given information I could not find a diagnosis, it could be an iron deficiency anemia but this would not explain the acute onset (….)”

(diagnosis missing, correct diagnosis: AV-node-reentry-tachycardia)