Cited by 1,675Clinical Reasoning and Diagnostic SkillsPatient Safety and Medication ErrorsDecision-Making and Behavioral Economics

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The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them

Croskerry, Pat·2003·Academic Medicine

DOI 10.1097/00001888-200308000-00003

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Abstract

In the area of patient safety, recent attention has focused on diagnostic error. The reduction of diagnostic error is an important goal because of its associated morbidity and potential preventability. A critical subset of diagnostic errors arises through cognitive errors, especially those associated with failures in perception, failed heuristics, and biases; collectively, these have been referred to as cognitive dispositions to respond (CDRs). Historically, models of decision-making have given insufficient attention to the contribution of such biases, and there has been a prevailing pessimism against improving cognitive performance through debiasing techniques. Recent work has catalogued the major cognitive biases in medicine; the author lists these and describes a number of strategies for reducing them ("cognitive debiasing"). Principle among them is metacognition, a reflective approach to problem solving that involves stepping back from the immediate problem to examine and reflect on the thinking process. Further research effort should be directed at a full and complete description and analysis of CDRs in the context of medicine and the development of techniques for avoiding their associated adverse outcomes. Considerable potential exists for reducing cognitive diagnostic errors with this approach. The author provides an extensive list of CDRs and a list of strategies to reduce diagnostic errors.

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Authors: Croskerry, P.
Affiliations: Dalhousie University (CA)
Corresponding author: Croskerry, Pat
ORCID: Croskerry, Pat
Venue: Academic Medicine
Publisher: Oxford University Press (OUP)
Published: 2003-08
Volume: 78
Issue: 8
Pages: 775-780
ISSN: 1040-2446 (ISSN-L)
DOI: 10.1097/00001888-200308000-00003
OpenAlex: W1967291734
Cited by: 1,675
References: 20
Citations by year: 2026: 186 · 2025: 83 · 2024: 74 · 2023: 83 · 2022: 87 · 2021: 103 · 2020: 120 · 2019: 91 · 2018: 85 · 2017: 87 · 2016: 117 · 2015: 73 · 2014: 86 · 2013: 92 · 2012: 66
FWCI: 12.57
Type: journal article
Language: en
Open access: closed
Locations: Academic Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: Agency for Healthcare Research and Quality (P20HS11592-02)
Topics: Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
Keywords: diagnostic errors, cognitive errors, cognitive biases, cognitive debiasing, metacognition, heuristics, perceptual errors, clinical decision-making, patient safety
MeSH terms: Cognition, Decision Support Techniques, Diagnostic Errors, Humans

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The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them

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