Publications by authors named "Kees Van den Berge"
Background: Patients who display disruptive behaviours in the clinical encounter (the so-called 'difficult patients') may negatively affect doctors' diagnostic reasoning, thereby causing diagnostic errors. The present study aimed at investigating the mechanisms underlying the negative influence of difficult patients' behaviours on doctors' diagnostic performance.
Methods: A randomised experiment with 74 internal medicine residents.
Background: Literature suggests that patients who display disruptive behaviours in the consulting room fuel negative emotions in doctors. These emotions, in turn, are said to cause diagnostic errors. Evidence substantiating this claim is however lacking.
View Article and Find Full Text PDFPurpose: Anecdotal evidence indicates that exposure to media-distributed disease information, such as news about an outbreak, can lead physicians to errors; influenced by an availability bias, they misdiagnose patients with similar-looking but different diseases. The authors investigated whether exposure to media-provided disease information causes diagnostic errors and whether reflection (systematic review of findings) counteracts bias.
Method: In 2010, 38 internal medicine residents first read the Wikipedia entry about one or another of two diseases (Phase 1).
Purpose: Diagnostic errors have been attributed to faulty reasoning and cognitive biases, but minimizing errors requires understanding the mechanisms underlying biases. The authors investigated whether salient distracting features (SDFs)-case findings that tend to grab physicians' attention because they are strongly associated with a particular disease, but are indeed unrelated to the problem-misdirect diagnostic reasoning, causing errors.
Method: In a 2012 study conducted at Erasmus Medical Centre, Rotterdam, 72 internal medicine residents diagnosed 12 clinical cases (6 simple, 6 complex) in three different formats: without a SDF, with a SDF in the beginning, and with a SDF at the end.
Medical error poses an important healthcare burden and a challenge for physicians and policy makers worldwide. Diagnostic error accounts for a substantial fraction of all medical mistakes. Most diagnostic errors have been associated with flaws in clinical reasoning.
View Article and Find Full Text PDFBackground: Psychological research has shown that people tend toward accepting rather than refuting hypotheses. Diagnostic suggestions may evoke such confirmatory tendencies in physicians, which may lead to diagnostic errors.
Purpose: This study investigated the influence of a suggested diagnosis on physicians' diagnostic decisions on written clinical cases.
Background: Studies suggest that residents tend to accept diagnostic suggestions, which could lead to diagnostic errors if the suggestion is incorrect. Those studies did not take into account that physicians in clinical practice will mainly encounter correct suggestions. The present study investigated residents' diagnostic performance if they would first encounter a number of correct suggestions followed by a number of incorrect suggestions, and vice versa.
View Article and Find Full Text PDFContext: Diagnostic errors have been associated with bias in clinical reasoning. Empirical evidence on the cognitive mechanisms underlying biases and effectiveness of educational strategies to counteract them is lacking.
Objectives: To investigate whether recent experience with clinical problems provokes availability bias (overestimation of the likelihood of a diagnosis based on the ease with which it comes to mind) resulting in diagnostic errors and whether reflection (structured reanalysis of the case findings) counteracts this bias.