An elderly woman with ‘heart failure’: Cognitive biases and diagnostic error
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Errors in diagnosis can arise from the clinician's cognitive biases as well as from problems in the healthcare system. Here the authors review a case with a bad outcome to analyze what went wrong and why.
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In one illustrative case (case 1), an older adult patient presented with symptoms of shortness of breath on exertion and cough, leading to an initial misdiagnosis of heart failure; further investigation revealed miliary tuberculosis.
“For example, in one illustrative case (case 1 [32]), an older adult patient presented with symptoms of shortness of breath on exertion and cough, leading to an initial misdiagnosis of heart failure. However, further investigation, considering her ongoing treatment with infliximab for rheumatoid arthritis, revealed the actual diagnosis of miliary tuberculosis.”
From Mitigating cognitive biases in clinical decision-making through multi-agent conversations using large language models: simulation study (2024) · cites this paper as [32]
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- Authors
- Mull, N., Reilly, J. B., & Myers, J. S.
- Affiliations
- University of Pennsylvania Health System (US)
- Allegheny Health Network (US)
- University of Pennsylvania (US)
- ORCID
- Mull, Nikhil
- Venue
- Cleveland Clinic Journal of Medicine
- Publisher
- Cleveland Clinic Journal of Medicine
- Published
- 2015-11
- Volume
- 82
- Issue
- 11
- Pages
- 745-753
- ISSN
- 0891-1150 (ISSN-L)
- 1939-2869
- OpenAlex
- W2397711955
- Cited by
- 9
- References
- 46
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2018: 3 · 2017: 1 · 2016: 1
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cleveland Clinic Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- diagnostic errors, cognitive biases, heart failure, older women, clinical reasoning, case review, health system challenges
- MeSH terms
- Aged, Clinical Competence, Cognition, Diagnosis, Differential, Diagnostic Errors, Female, Heart Failure, Humans, Bias
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