Suárez RB, Blanco AMA, Morales JE, Suárez RA

Language: Spanish
References: 11
Page: 271-282
PDF size: 90.58 Kb.

ABSTRACT

Introduction: diagnosis is both an end and an indispensable means to establish an effective treatment. To some it is the most important part of medical practice. However, there are difficulties related to the way it should be taught.
Objective: determine the relationship between errors in diagnostic discussion and diagnostic certainty.
Methods: a descriptive study was conducted based on the analysis of 75 diagnostic discussions written and presented by 36 internal medicine specialists from Dr. Carlos J. Finlay Central Military Hospital. All discussions were analyzed by three professors based on an observation guide. The three professors would then discuss their observations with a view to defining the errors made during diagnostic discussion.
Results: the most common errors were the following: not dealing with the disorder or condition, not making a prognosis, wrong etiological diagnosis and wrong nosological entity, the latter two with statistically significant differences.
Conclusions: there exist conceptual limitations as to what to include in the diagnosis as results. Most errors are not significantly associated with diagnostic certainty.

REFERENCES

1. Ilizástegui Dupuy F. El método clínico: muerte y resurrección. Ateneo. 2000;1(2):85-9.

2. MINSAP. Formulario Nacional de Medicamentos. La Habana: Ciencias Médicas; 2003. p. 14-20.

3. Cutler P. Cómo solucionar problemas en clínica médica. Río de Janeiro: Guanabara Koogan; 1999. p. 3-88.

4. Selman-Houssein Abdo E. Guía de acción para la excelencia en la atención médica. La Habana: Ciencias Médicas; 2003. p. 10-6.

5. Bloch RF, Hofer D, Feller S, Hodel M. The role of strategy and redundancy in diagnostic reasoning. BMC Med Educ. 2003;3(1):1-5.

6. Díaz Novás J, Fernández Sacasas J, Guerrero Figueredo A. El diagnóstico en la atención primaria. Rev Cubana Med Gen Integr. 1993;9(2):150-5.

7. Santana Tellez NT, Del Águila Grandez AY, Villalonga Moras Y. Del Risco Turiño C. Deficiencias en la aplicación del método clínico en estudiantes de tercer año de medicina. Rev Hum Med [Internet]. 2007 Abr [citado 15 Abr 2010 ]; 7(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-81202007000100010&lng=es

8. Moreno Rodríguez MA. El arte y la ciencia del diagnóstico médico. La Habana: Científico-Técnica; 2001. p. 47-166.

9. Shalowitz M. The physician's office laboratory in modern medical practice. Med Clin North Am. 1969;53:3-9.

10. Leithold SL, Friedman IA. Laboratory aids in the recognition of bleeding disorders. Med Clin North Am. 1969;53:61-78.

11. Scott J. Why are we killing clinical medicine? J Fla Med Assoc. 1979 Dec; 66(12):1232-6.