Advancing diagnostic excellence: the cognitive challenge for medicine
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Some clinicians may be influenced by cognitive and affective biases and/or concerns regarding social or professional approbation, which might lead to denial.
“Some may be influenced by a host of cognitive and affective biases and/or concerns regarding social or professional approbation [25–27], which might lead some clinicians to forms of denial, in which they essentially avoid facing the realities of these terminal states.”
Cites
Diagnostic error in internal medicine
Graber, M. L., Franklin, N., & Gordon, R. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.13.1493 · Cited by 1,549 · see citing works
Royce, C. S., Hayes, M. M., & Schwartzstein, R. M. (2019) · Academic Medicine · doi:10.1097/acm.0000000000002518 · Cited by 242 · see citing works
Thinking about diagnostic thinking: a 30-year perspective
Elstein, A. S. (2009) · Advances in Health Sciences Education · doi:10.1007/s10459-009-9184-0 · Cited by 205 · see citing works
Rencic, J. J., Trowbridge, R. L., Fagan, M. J., Szauter, K. M., & Durning, S. J. (2017) · Journal of General Internal Medicine · doi:10.1007/s11606-017-4159-y · Cited by 154 · see citing works
Better clinical decision making and reducing diagnostic error
Croskerry, P., & Nimmo, G. R. (2011) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.4997/jrcpe.2011.208 · Cited by 148 · see citing works
Self-citationDecision‐making heuristics and biases across the life span
Strough, J., Karns, T. E., & Schlosnagle, L. (2011) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2011.06208.x · Cited by 129 · see citing works
Problems for clinical judgement: introducing cognitive psychology as one more basic science.
Redelmeier, D. A., Ferris, L. E., Tu, J. V., Hux, J. E., & Schull, M. J. (2001) · Europe PMC (PubMed Central) · Cited by 120 · see citing works
Five strategies for clinicians to advance diagnostic excellence
Singh, H., Connor, D. M., & Dhaliwal, G. (2022) · BMJ · doi:10.1136/bmj-2021-068044 · Cited by 63 · see citing works
Croskerry, P. (2020) · doi:10.1093/med/9780190088743.001.0001 · Cited by 23 · see citing works
Self-citationBonifacino, E., Follansbee, W. P., Farkas, A. H., Jeong, K., McNeil, M., & DiNardo, D. J. (2019) · Diagnosis · doi:10.1515/dx-2018-0063 · Cited by 19 · see citing works
The Rational Diagnostician and Achieving Diagnostic Excellence
Croskerry, P. (2022) · JAMA · doi:10.1001/jama.2021.24988 · Cited by 19 · see citing works
Self-citationDecision – Diagnosis: An Introduction to Diagnostic Error and Medical Decision-Making
Ruedinger, E., Mathews, B. K., & Olson, A. P. J. (2016) · MedEdPORTAL · doi:10.15766/mep_2374-8265.10378 · Cited by 10 · see citing works
Hunzeker, A., & Amin, R. (2016) · MedEdPORTAL · doi:10.15766/mep_2374-8265.10451 · Cited by 7 · see citing works
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Yager, J., Gaudiani, J. L., & Treem, J. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00659-x · Cited by 24 · see citing works
FRAMED: a framework facilitating insight problem solving
Isoda, S., Shimizu, T., & Suzuki, T. (2024) · Diagnosis · doi:10.1515/dx-2023-0152 · Cited by 4 · see citing works
Manojlovich, M., Cassady, C. M., Parker, S. J., Davis, E., Ahr, C. J., Ryamukuru, D., Wang, A., Pasupathy, K. S., Singh, H., & Mahajan, P. (2025) · Academic Emergency Medicine · doi:10.1111/acem.70142 · Cited by 2 · see citing works
The Quest for Diagnostic Excellence in the Emergency Department
Pulia, M. S., Papanagnou, D., & Croskerry, P. (2024) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/j.jcjq.2024.05.004 · Cited by 1 · see citing works
Self-citationA Reflective Verbalization Strategy to Trigger Alternative Diagnostic Hypotheses
Isoda, S., Shimizu, T., Hashimoto, T., Shimada, F., Misawa, M., & Suzuki, T. (2025) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.70267
Elicit and Enhance: Advancing Multimodal Reasoning in Medical Scenarios
Huang, Z., Mu, L., Gu, Y., Hu, K., Hua, S., & Zhang, X. (2026) · doi:10.1109/cvprf71909.2026.00539
- Authors
- Croskerry, P., & Clancy, M.
- Affiliations
- Dalhousie University (CA)
- Southampton General Hospital (GB)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2022-03-29
- Volume
- 376
- Pages
- o799
- ISSN
- 1756-1833 (ISSN-L)
- OpenAlex
- W4220956924
- Cited by
- 6
- References
- 13
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2022: 1
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- diagnosis, diagnostic reasoning, clinical decision-making
- MeSH terms
- Cognition, Humans, Medicine
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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