In their 2008, 22-page article “
Overconfidence as a Cause of Diagnostic Error in Medicine,”
Eta S.
Berner,
EdD and Mark L.
Graber, MD provided a tour de force job of addressing this in detail.
I’ve reproduced their Table 2 below, which provides a summary of their findings.
The article did a splendid job of highlighting the scope of the problem as being well beyond internal medicine, as might have been suggested by my last post.
It provided hundreds of references, highlighting the problem and range of historically attempted approaches, like computer-based diagnostic decision support tools (a form of CDS or clinical decision support), that have had limited impact.
According to the authors, “For many clinicians, these factors (elaborated in the article) may make the perceived utility of these systems not worth the cost and effort to use
them.” I am grateful to both
Drs.
Berner and
Graber for their fabulous review, their editorial work on
an entire supplemental issue of The American Journal of Medicine on this topic, and their personal support through email and other personal communications.