Diagnosis

Pat Croskerry is Professor of Emergency Medicine and in Medical Education at Dalhousie University in Halifax, Nova Scotia, Canada. He has been a contributor to the annual conference of the Society for Improvement in Diagnosis since its inception. He has published over 80 journal articles and 30 book chapters in the area of patient safety, clinical decision making and medical education reform. In 2006 he was appointed to the Board of the Canadian Patient Safety Institute, and in the same year received the Ruedy award from the Association of Faculties of Medicine of Canada for innovation in medical education. He is senior editor of Patient Safety in Emergency Medicine (2009). He was appointed Director of the new Critical Thinking Program at Dalhousie Medical School, and a Fellow of the Royal College of Physicians of Edinburgh in 2012. In 2014, he was appointed to the US Institute of Medicine Committee on Diagnostic Error in Medicine.

Despite diagnosis being the key feature of a physician's clinical performance, this is the first book that deals specifically with the topic. In recent years, however, considerable interest has been shown in this area and significant developments have occurred in two main areas: a) an awareness and increasing understanding of the critical role of clinical decision making in the process of diagnosis, and of the multiple factors that impact it, and b) a similar appreciation of the role of the healthcare system in supporting clinicians in their efforts to make accurate diagnoses. Although medicine has seen major gains in knowledge and technology over the last few decades, there is a consensus that the diagnostic failure rate remains in the order of 10-15%. This book provides an overview of the major issues in this area, in particular focusing on where the diagnostic process fails, and where improvements might be made.

Preface; Section I: Models of Diagnosis; Chapter 1: What is Diagnosis?; Chapter 2: Medical Decision Making; Chapter 3: Modern Cognitive Approaches to the Diagnostic Process; Section II: Informal and Alternative Approaches to Diagnosis; Chapter 4: Alternatives to Conventional Medical Diagnosis; Chapter 5: Complementary and Alternative Medicine; Section III: The Elements of Reasoning; Chapter 6: Stone Age Minds in Modern Medicine: Ancient Footprints Everywhere; Chapter 7. Cognitive and Affective Biases, and Logical Failures; Chapter 8: The Rational Diagnostician; Chapter 9: Individual Variability in Clinical Decision Making and Diagnosis; Section IV: Challenges and Controversies in Diagnosis; Chapter 10: Diagnostic Error; Chapter 11: The Role of the Healthcare System in Diagnostic Success or Failure; Chapter 12: Do Teams Make Better Diagnoses?; Chapter 13: How Much Diagnosis Can We Afford?; Section V: The Fix; Chapter 14: Medical Education and the Diagnostic Process; Chapter 15: Cognitive Bias Mitigation: Becoming Better Diagnosticians; Chapter 16: Diagnostic Support from Information Technology; Chapter 17: What is the Patient's Role in Diagnosis?; Appendix A. Cognitive Biases; Appendix B. Logical Fallacies; Glossary; Afterward