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Some Physicians Are Overconfident about Their Diagnostic Accuracy

Accurate diagnoses are crucial for good medical care. New research shows, however, that doctors are not as good as they think at making accurate diagnoses. There is also a disturbing disconnect between their accuracy and their confidence in a diagnosis.

The investigators recruited 118 physicians and presented them with four diagnostic vignettes ranging in complexity from easy to difficult. The doctors were also queried on their confidence in their diagnostic accuracy. The results were not encouraging. About half the physicians got the easy diagnoses correct, but only 6 percent came up with the correct diagnosis on the most difficult cases. (The fact that nearly half got the easy diagnoses wrong is more than a little unsettling.)

Strangely, their level of confidence in the accuracy of their diagnoses was almost the same for easy AND difficult cases. The researchers conclude that the mismatch between accuracy and confidence might keep doctors from reexamining difficult cases when their diagnosis is incorrect.

[JAMA Internal Medicine, online, Aug. 26, 2013]

Some patients may want to take action of their own to assist when they suspect the diagnosis may not be quite right. Here’s one such story.  Another approach would be to use a symptom checker such as Isabel to get some idea of the various problems that might be causing those symptoms. This is not meant to take the place of a doctor doing a proper diagnostic work-up, but rather to ask the doctor if he or she can rule out the other possibilities, and why. It is never a bad idea to ask the doctor, “What else could it be?”

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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