a. Faulty knowledge
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a. Faulty knowledge
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Knowledge base inadequate or defective
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Insufficient Knowledge of relevant condition
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Providers not aware of fournier gangrene
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Lack of knowledge of a necessary therapeutic action
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Clinician has insufficient knowledge of all therapeutic steps
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Basis medication is incomplete or completely forgotten
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Lack of knowledge of a special indication
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Clinician has insufficient knowledge of a special indication for a specific therapeutic action
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Patient with reoccurring vertebral body fractures receives alendronate (teriparatide would be indicated)
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Lack of knowledge of contraindications
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Clinician has insufficient knowledge of all contraindications
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Patient with severe kidney failure is prescribed a bisphosphonate therapy
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b. Faulty Synthesis: Faulty information processing
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b. Faulty context generation and interpretation
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Faulty context generation
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Lack of awareness/consideration of aspects of patient’s situation that are relevant to diagnosis
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Missed perforated ulcer in a patient presenting with chest pain and laboratory evidence of myocardial infarction
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Misidentification of information as a contraindication
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Clinician identifies given information as faulty as a contraindication
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Wrong contraindications are stated (young age, certain medication, male sex)
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Failure in recognizing contraindications
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Clinician fails to identify information as a contraindication
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Female patient with risk for thrombosis receives estrogen
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Overestimating or underestimating usefulness or salience of a finding
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Clinician is aware of symptom but either focuses too closely on it to the exclusion of others or fails to appreciate its relevance
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Wrong diagnosis of sepsis in a patient with stable leukocytosis in the setting of myelodysplastic syndrome
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Underestimation of a finding in the process of considering patients` individual risk
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Deficiency in interpreting the patient’s individual 10-year -fracture-risk, leading to an underestimation
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Advanced patient age or female sex is overlooked; the T-score is miscalculated
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Faulty interpretation of results resulting in “undertreatment”
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Clinician interprets given information as faulty, resulting in too little of an amount of therapy for the patient
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post-menopausal condition is overlooked
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Overestimation of a finding in the process of considering patients’ individual risks
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Deficiency in interpreting the patient’s individual 10-year-fracture-risk, leading to an overestimation
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BMI is misjudged; the T-score is miscalculated
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Faulty interpretation of results resulting in “overtreatment”
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Clinician interprets given information as faulty, resulting in too much of an amount of therapy for the patient
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Fractures on non-osteoporosis relevant party of the body are included in risk calculation (e.g., rib, toe, …)
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Failure to leave the common path of procedures
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Clinician sticks to common therapy ignoring a special indication
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In this case, the participant stated that ‘that the decision is based on personal experience’
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c. Faulty synthesis: Faulty Verification
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c. Faulty metacognition
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Premature closure
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Failure to consider other possibilities once an initial diagnosis has been reached
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Wrong diagnosis of musculoskeletal pain after a car crash: ruptured spleen ultimately found
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Possible overconfidence
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Clinician fails to question their own findings
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Necessary additional consult with a specialist is not performed (patient case with severe mastocytosis)
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Failure to consult
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Appropriate expert is not contacted
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Hyponatremia inappropriately ascribed to diuretics in a patient later found to have lung cancer; no consultations requested
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Lack of confidence
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Clinician fails to trust their own findings
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Additional consult with a specialist with a low threshold
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