Ten Principles for More Conservative, Care-Full Diagnosis
Authors: Thierry Pelaccia
Journal: Annals of Internal Medicine (2019)

Letters4 June 2019Ten Principles for More Conservative, Care-Full DiagnosisThierry Pelaccia, MD, MEd, PhDThierry Pelaccia, MD, MEd, PhDCentre for Training and Research in Health Sciences Education, University of Strasbourg, Strasbourg, France (T.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0147 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Schiff and colleagues' commentary (1) deals with a crucial subject. As the authors note, diagnostic errors frequently occur and constitute a major issue for public health and quality of care. Makary and Daniel (2) recently stated that medical error—the most common of which is diagnostic—is the third leading cause of death in the United States. Schiff and colleagues' commentary provides many avenues for reflection that physicians should consider and that require additional research.The authors note that “time is a powerful incubator for diagnosis” and “having adequate time to listen, observe, discuss, and reflect is a decisive ...References1. Schiff GD, Martin SA, Eidelman DH, Volk LA, Ruan E, Cassel C, et al. Ten principles for more conservative, care-full diagnosis. Ann Intern Med. 2018;169:643-5. [PMID: 30285046]. doi:10.7326/M18-1468 LinkGoogle Scholar2. Makary MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ. 2016;353:i2139. [PMID: 27143499] doi:10.1136/bmj.i2139 CrossrefMedlineGoogle Scholar3. Croskerry P. When I say … cognitive debiasing. Med Educ. 2015;49:656-7. [PMID: 26077213] doi:10.1111/medu.12670 CrossrefMedlineGoogle Scholar4. Norman GR, Monteiro SD, Sherbino J, Ilgen JS, Schmidt HG, Mamede S. The causes of errors in clinical reasoning: cognitive biases, knowledge deficits, and dual process thinking. Acad Med. 2017;92:23-30. [PMID: 27782919] doi:10.1097/ACM.0000000000001421 CrossrefMedlineGoogle Scholar5. Sherbino J, Dore KL, Wood TJ, Young ME, Gaissmaier W, Kreuger S, et al. The relationship between response time and diagnostic accuracy. Acad Med. 2012;87:785-91. [PMID: 22534592] doi:10.1097/ACM.0b013e318253acbd CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Centre for Training and Research in Health Sciences Education, University of Strasbourg, Strasbourg, France (T.P.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0147. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTen Principles for More Conservative, Care-Full Diagnosis Gordon D. Schiff , Stephen A. Martin , David H. Eidelman , Lynn A. Volk , Elise Ruan , Christine Cassel , William Galanter , Mark Johnson , Annemarie Jutel , Kurt Kroenke , Bruce L. Lambert , Joel Lexchin , Sara Myers , Alexa Miller , Stuart Mushlin , Lisa Sanders , and Aziz Sheikh Ten Principles for More Conservative, Care-Full Diagnosis James L. Meisel Ten Principles for More Conservative, Care-Full Diagnosis Gordon D. Schiff , Kurt Kroenke , Bruce L. Lambert , Lisa Sanders , and Aziz Sheikh Ten Principles for More Conservative, Care-Full Diagnosis Katherine Rediger and Bailey Miles Metrics Cited byRe-thinking morbidity and mortality 4 June 2019Volume 170, Issue 11Page: 823KeywordsConflicts of interestDisclosureHealth care qualityMemoryPrevention, policy, and public health ePublished: 4 June 2019 Issue Published: 4 June 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...