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Diagnostic error

Bhavik N Modi, Kalpa De Silva, Ronak Rajani, Nick Curzen, Divaka Perera
Importance: Ischemia-guided revascularization is the cornerstone of contemporary management of coronary artery disease and has evolved from noninvasive functional evaluation to real-time assessment with invasive physiological indices during diagnostic catheterization. However, serial/diffuse disease is common, and revascularization decisions often need to be made about individual lesions within the same vessel. It is unclear whether current physiological techniques, such as fractional flow reserve, can be reliably used to discern the individual contribution of lesions within a serially diseased vessel with erroneous measurements, potentially leading to suboptimal revascularization decisions...
March 21, 2018: JAMA Cardiology
A A Polyantsev, A V Bykov, A A Polyantsev, V V Kotrunov, A G Zimin, Yu A Dyachkova
AIM: To analyze the errors and complications of surgical care in patients with the first episode of spontaneous pneumothorax at different hospitals. MATERIAL AND METHODS: From 2005 to 2015 three hundreds and seventeen patients with the first episode of spontaneous pneumothorax have been treated at the thoracic department of Volgograd State Medical University. Patients were divided into 2 groups: 79 of them underwent thoracotomy while in 238 cases minimally invasive technologies were applied...
2018: Khirurgiia
Blake S Raggio, Samuel C Ficenec, Jason Pou, Brian Moore
Background: Acute calcific tendonitis of the longus colli (ACTLC) is an aseptic inflammatory response to deposition of calcium in the longus colli muscle tendons. Although reports in the literature are scarce, ACTLC likely represents an underreported disease process that routinely goes misdiagnosed. We report a case of ACTLC and provide a brief review of the literature. Case Report: A 45-year-old otherwise healthy female presented with a 3-day history of progressive neck pain, decreased neck mobility, and odynophagia...
2018: Ochsner Journal
Ana Flores-Justa, Elena López-García, Alfredo García-Allut, Rosa María Reyes-Santías
Solitary fibrous tumours/haemangiopericytomas (SFT/HPC) are fibroblastic mesenchymal neoplasms that harbour a genetic fusion of NAB2/STAT6. There are few reported cases in the central nervous system (CNS), of which spinal tumours are minority. We present a case of a 63-year-old woman with progressive paraparesis and a sensory level of T6. On the MRI we detected an intradural extramedullary lesion on T9-T10. We performed a laminectomy with an intraoperative ultrasound study in which we observed a heterogeneous lesion with an infiltrating pattern affecting the medulla at several points, and resection of the lesion...
March 17, 2018: Neurocirugía
Trine Printz, Camilla Slot Mehlum, Gohar Nikoghosyan-Bossen
Childhood apraxia of speech and oral dyspraxia are subtypes of dyspraxia: a neurological motor disorder with absence of neuromuscular deficits. The core impairment is in planning and/or programming spatiotemporal parameters of movement sequences, which results in errors in speech sound production and prosody, or in oral motor movements and gestures. Correct diagnostics and focus on differential diagnoses and co-morbidity are crucial, as treatment differs from other types of speech- and oral motor disorders...
March 19, 2018: Ugeskrift for Laeger
Yoshitaka Inui, Takashi Ichihara, Masaki Uno, Masanobu Ishiguro, Kengo Ito, Katsuhiko Kato, Hajime Sakuma, Hidehiko Okazawa, Hiroshi Toyama
OBJECTIVE: Statistical image analysis of brain SPECT images has improved diagnostic accuracy for brain disorders. However, the results of statistical analysis vary depending on the institution even when they use a common normal database (NDB), due to different intrinsic spatial resolutions or correction methods. The present study aimed to evaluate the correction of spatial resolution differences between equipment and examine the differences in skull bone attenuation to construct a common NDB for use in multicenter settings...
March 19, 2018: Annals of Nuclear Medicine
Monique Piraud, Magali Pettazzoni, Pamela Lavoie, Séverine Ruet, Cécile Pagan, David Cheillan, Philippe Latour, Christine Vianey-Saban, Christiane Auray-Blais, Roseline Froissart
Tandem mass spectrometry (MS/MS) is a highly sensitive and specific technique. Thanks to the development of triple quadrupole analyzers, it is becoming more widely used in laboratories working in the field of inborn errors of metabolism. We review here the state of the art of this technique applied to the diagnosis of lysosomal storage disorders (LSDs) and how MS/MS has changed the diagnostic rationale in recent years. This fine technology brings more sensitive, specific, and reliable methods than the previous biochemical ones for the analysis of urinary glycosaminoglycans, oligosaccharides, and sialic acid...
March 19, 2018: Journal of Inherited Metabolic Disease
Jonathan R Weir-McCall, Liam Brown, Jennifer Summersgill, Piotr Talarczyk, Michael Bonnici-Mallia, Sook C Chin, Faisel Khan, Allan D Struthers, Frank Sullivan, Helen M Colhoun, Angela C Shore, Kunihiko Aizawa, Leif Groop, Jan Nilsson, John R Cockcroft, Carmel M McEniery, Ian B Wilkinson, Yoav Ben-Shlomo, J Graeme Houston
Current distance measurement techniques for pulse wave velocity (PWV) calculation are susceptible to intercenter variability. The aim of this study was to derive and validate a formula for this distance measurement. Based on carotid femoral distance in 1183 whole-body magnetic resonance angiograms, a formula was derived for calculating distance. This was compared with distance measurements in 128 whole-body magnetic resonance angiograms from a second study. The effects of recalculation of PWV using the new formula on association with risk factors, disease discrimination, and prediction of major adverse cardiovascular events were examined within 1242 participants from the multicenter SUMMIT study (Surrogate Markers of Micro- and Macrovascular Hard End-Points for Innovative Diabetes Tools) and 825 participants from the Caerphilly Prospective Study...
March 19, 2018: Hypertension
Guogen Shan, Hua Zhang, Tao Jiang
To compare a new binary diagnostic test with the gold standard, sensitivity and specificity are the two common measurements used to evaluate the new test. When not all the patients are verified by the gold standard due to time, budget, or cost considerations, several approaches have been proposed to compute sample size for such studies under the assumption of missing completely at random. However, the majority of them are based on asymptotic approaches that generally do not guarantee the type I and II error rates, and the remaining approaches use exact binomial distributions in sample size calculation but only the verified samples are used...
March 19, 2018: Journal of Biopharmaceutical Statistics
Bing Wu, Yi Yang, Shuai Zhou, Wei Wang, Zizhen Wang, Gang Hu, Jianghong He, Xinhuai Wu
Purpose: Diagnostic error is common among patients with vegetative state (VS) and minimally conscious state (MCS). The purpose of this article is to use three-dimensional pseudo-continuous arterial spin labeling (pcASL) to compare cerebral blood flow (CBF) patterns in patients in MCS with those in VS. Methods: Patients meeting MCS and VS criteria were identified. Two post-labeling delay (PLD) time pcASL on 3.0-Tesla magnetic resonance imaging scanner system were performed with patients in the resting awake state...
2018: Frontiers in Neurology
Ketan K Mane, Kevin B Rubenstein, Najlla Nassery, Adam L Sharp, Ejaz A Shamim, Navdeep S Sangha, Ahmed Hassoon, Mehdi Fanai, Zheyu Wang, David E Newman-Toker
No abstract text is available yet for this article.
March 17, 2018: BMJ Quality & Safety
Marko Barjaktarović, Milica M Janković, Marija Jeremić, Milovan Matović
Radioiodine therapy in the treatment of differentiated thyroid carcinoma (DTC) is used in clinical practice for the ablation of thyroid residues and/or destruction of tumour tissue. Whole-body scintigraphy for visualization of the spatial 131I distribution performed by a gamma camera (GC) is a standard procedure in DTC patients after application of radioiodine therapy. A common problem is the precise topographic localization of regions where radioiodine is accumulated even in SPECT imaging. SPECT/CT can provide precise topographic localization of regions where radioiodine is accumulated, but it is often unavailable, especially in developing countries because of the high price of the equipment...
March 9, 2018: Computers in Biology and Medicine
Nicola Schieda, Robert S Lim, Satheesh Krishna, Matthew D F McInnes, Trevor A Flood, Rebecca E Thornhill
OBJECTIVE: The objective of our study was to evaluate tumor attenuation and texture on unenhanced CT for potential differentiation of low-grade from high-grade chromophobe renal cell carcinoma (RCC). MATERIALS AND METHODS: A retrospective study of 37 consecutive patients with chromophobe RCC (high-grade, n = 13; low-grade, n = 24) who underwent preoperative unenhanced CT between 2011 and 2016 was performed. Two radiologists (readers 1 and 2) blinded to the histologic grade of the tumor and outcome of the patients subjectively evaluated tumor homogeneity (3-point scale: completely homogeneous, mildly heterogeneous, or mostly heterogeneous)...
March 16, 2018: AJR. American Journal of Roentgenology
Ayesha Sohail, O A Bég, Zhiwu Li, Sebahattin Celik
The mathematics of imaging is a growing field of research and is evolving rapidly parallel to evolution in the field of imaging. Imaging, which is a sub-field of biomedical engineering, considers novel approaches to visualize biological tissues with the general goal of improving health. "Medical imaging research provides improved diagnostic tools in clinical settings and supports the development of drugs and other therapies. The data acquisition and diagnostic interpretation with minimum error are the important technical aspects of medical imaging...
March 12, 2018: Progress in Biophysics and Molecular Biology
Mamadou Alpha Diallo, Khadim Diongue, Mame Cheikh Seck, Mouhamadou Ndiaye, Ibrahima Diallo, Younouss Diedhiou, Tolla Ndiaye, Yaye Die Ndiaye, Aida Sadikh Badiane, Daouda Ndiaye
BACKGROUND: In developing countries, malaria diagnosis relies on microscopy and rapid diagnostic tests. In Senegal, national malaria control program (NMCP) regularly conducts supervisory visits in health services where malaria microscopy is performed. In this study, expert microscopists assessed the performance of laboratory technicians in malaria microscopy. METHODS: The present external quality assessment (EQA) was conducted in three different areas of malaria transmission...
March 15, 2018: Annals of Clinical Microbiology and Antimicrobials
Longchao Yao, Jun Chen, Paul E Sojka, Xuecheng Wu, Kefa Cen
Dynamic stringy objects such as liquid rims and ligaments are frequently observed in important applications such as the multiphase breakup of fuel droplets. We develop a new method based on digital in-line holography to automatically measure complicated stringy objects. A static spring mounted on a rotator is measured to validate the effectiveness and accuracy of the method. The sections are extracted along the skeleton of the spring in a depth-of-field extended image and then sized and located as individual particles using a hybrid method...
March 15, 2018: Optics Letters
Renata C Gallagher, Laura Pollard, Anna I Scott, Suzette Huguenin, Stephen Goodman, Qin Sun
Disclaimer: These ACMG Standards are intended as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these Standards is voluntary and does not necessarily assure a successful medical outcome. These Standards should not be considered inclusive of all proper procedures and tests, or exclusive of others that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, clinical laboratory geneticists should apply their professional judgment to the specific circumstances presented by the patient or specimen...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Yet Yen Yan, Jenn Nee Khoo, Tien Jin Tan, Joe Francis, Le Roy Chong, Elizabeth Hui-Ying Chan
PURPOSE: To review the errors made by radiology trainees in the reporting of cervical spine CTs (CCT) and to compare the discrepancy rates between the stages of training. METHODS: All CCTs reported by trainees after office hours between January 2015 and December 2015 were retrospectively reviewed by a team of five musculoskeletal consultants with experience ranging between 7 and 15 years. Discrepancies between the provisional report by the trainee and the findings by the musculoskeletal consultants were graded according to the RADPEER scoring system...
March 14, 2018: Emergency Radiology
Mark L Graber, Colene Byrne, Doug Johnston
Diagnostic error may be the largest unaddressed patient safety concern in the United States, responsible for an estimated 40,000-80,000 deaths annually. With the electronic health record (EHR) now in near universal use, the goal of this narrative review is to synthesize evidence and opinion regarding the impact of the EHR and health care information technology (health IT) on the diagnostic process and its outcomes. We consider the many ways in which the EHR and health IT facilitate diagnosis and improve the diagnostic process, and conversely the major ways in which it is problematic, including the unintended consequences that contribute to diagnostic error and sometimes patient deaths...
November 27, 2017: Diagnosis
Andrés Pomi
BACKGROUND: One of the central challenges of third millennium medicine is the abatement of medical errors. Among the most frequent and hardiest causes of misdiagnosis are cognitive errors produced by faulty medical reasoning. These errors have been analyzed from the perspectives of cognitive psychology and empirical medical studies. We introduce a neurocognitive model of medical diagnosis to address this issue. METHODS: We construct a connectionist model based on the associative nature of human memory to explore the non-analytical, pattern-recognition mode of diagnosis...
November 27, 2017: Diagnosis
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