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Cited by 97Clinical Reasoning and Diagnostic SkillsPatient Safety and Medication ErrorsDecision-Making and Behavioral Economics

Diagnostic Failure: A Cognitive and Affective Approach: (448242006-001)

Croskerry, Pat·2005·PsycEXTRA Dataset
DOI 10.1037/e448242006-001
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Abstract

Diagnosis is the foundation of medicine. Effective treatment cannot begin until an accurate diagnosis has been made. Diagnostic reasoning is a critical aspect of clinical performance. It is vulnerable to a variety of failings, the most prevalent arising through cognitive and affective influences. The impact of diagnostic failure on patient safety does not appear to have been fully recognized. Ideally, all information used in diagnostic reasoning is objective and all thinking is logical and valid, but these conditions are not always met. Two major phenomena that may undermine objectivity and rational thinking are cognitive dispositions to respond (CDRs) and affective dispositions to respond (ADRs) toward the patient. In this report, the determinants and characteristics of the major CDRs and ADRs are reviewed, as are a variety of de-biasing strategies that may mitigate their influence. A retrospective analytical process, the cognitive and affective autopsy, is also described. The purpose of this report is to provide insight into cognitive and affective influences that have resulted in delayed or missed diagnoses.

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Crossref · 10.1037/e448242006-001

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Authors
Croskerry, P.
Corresponding author
Croskerry, Pat
ORCID
Croskerry, Pat
Venue
PsycEXTRA Dataset
Publisher
American Psychological Association (APA)
Published
2005
DOI
10.1037/e448242006-001
OpenAlex
W2158506930
Cited by
97
References
56
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 8 · 2021: 12 · 2020: 5 · 2019: 3 · 2018: 6 · 2017: 8 · 2016: 4 · 2015: 1 · 2014: 5 · 2013: 5 · 2012: 3
Type
dataset
Language
en
Open access
closed
Locations
  • PsycEXTRA Dataset (publishedVersion)
  • Defense Technical Information Center (DTIC) (submittedVersion)
Topics
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
  • Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
Keywords
diagnostic failure, diagnostic reasoning, cognitive biases, affective bias, patient safety, missed diagnosis, delayed diagnosis, physician-patient relationship

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