Abstract:
Diagnostic errors are often caused by cognitive biases and sometimes by other cognitive errors,
which are driven by factors specific to clinicians, patients, diseases, and health care systems. An
experienced clinician diagnoses routine cases intuitively, effortlessly, and automatically through
non-analytic reasoning and uses deliberate, cognitively effortful analytic reasoning to diagnose
atypical or complicated clinical cases. However, diagnostic errors can never be completely
avoided. To minimize the frequency of diagnostic errors, it is advisable to rely on multiple sources
of information including the clinician’s personal experience, expert opinion, principals of statistics,
evidence-based data, and well-designed algorithms and guidelines, if available. It is also important
to frequently engage in thoughtful, reflective, and metacognitive practices that can serve to
strengthen the clinician’s diagnostic skills, with a consequent reduction in the risk of diagnostic
error. The purpose of this narrative review was to highlight certain factors that influence the
genesis of diagnostic errors. Understanding the dynamic, adaptive, and complex interactions
among these factors may assist clinicians, managers of health care systems, and public health
policy makers in formulating strategies and guidelines aimed at reducing the incidence and prevalence
of the phenomenon of clinical diagnostic error, which poses a public health hazard.
