Some situations seem to be impossible, but sometimes they occur, according to the Reason model, when there is an “alignment” of latent conditions. This is an incredible but real story. A 62-year-old man was scheduled to undergo surgery for an inguinal hernia. Continue reading Amputation: red alarm
Article published by Professor Ximena Páez, professor at the Universidad de Los Andes de Venezuela. Co-author: Miguel Angel Díaz.
People in general are not satisfied,unfortunately, with their health system. Why? The causes are multiple and complex. Could providers and patients individually and independently produce changes to achieve better medical practice? Could teaching and care institutions help in this target? Continue reading Improving medical practice: a utopia?
Is our model of clinical practice exhausted? What are going to be the next challenges for the clinical practice in this century? Medicine needs to recover the meaning of the practice…
Some Situations prone to a missed diagnosis in cancer
|Lung cancer||False negative X-ray: delays six times longer.
Superior sulcus tumours treated for musculoskeletal shoulder pain.
Older and socially deprived groups
|Larynx||Performing mirror examination significantly shortened the professional diagnostic delay.
Women double probability of diagnostic delay
|Upper gastrointestinal||Taking acid suppression for symptoms delays the diagnosis|
|Gastrointestinal||Inappropriate use of a rapid access to an endoscopy service|
|Cervix cancer||Pregnancy: delayed diagnosis|
|Rectal cancer||Negative barium enema within the year prior to diagnosis as a cause of the delayed diagnosis||
Diagnostic delay in cancer is a difficult subject to study with many confounder factors. Several papers have been published with controversial results about the relationship between delay and survival, although there is a clear tendence for a worse prognosis with longer delays. We will expose some of the confounder factors and biases that can interact with the association between delay and survival.
This is real good news. Putting Diagnostic Improvement in practice. I,m sure The Center will be a reference for all who are working in the field 0f clinical reasoning and improving diagnosis. Dr.Newman-Toker is a brilliant and clever communicator and an expert in the field of Diagnostic error. Congratulations.