Patient cueing, a type of diagnostic error

Area of Science:

• Medical diagnosis
• Cognitive psychology
• Patient safety

Background:

• Diagnostic errors contribute significantly to patient harm.
• Psychological factors, including cognitive biases, are known contributors to diagnostic failure.
• Previous diagnostic errors by clinicians can influence subsequent diagnostic reasoning.

Observation:

• This case report details a patient who self-misdiagnosed a condition.
• The patient's self-diagnosis influenced the emergency room physician's initial assessment.
• Subsequent treating physicians were also led to the incorrect diagnosis due to the patient's initial misattribution.

Findings:

• The mechanism of diagnostic error observed was 'patient cueing'.
• Patient cueing occurs when a patient's incorrect self-diagnosis or presentation directs the clinician toward a specific, potentially wrong, diagnostic pathway.
• This highlights the impact of patient perception and communication on clinical decision-making.

Implications:

• Recognizing and mitigating patient cueing is crucial for improving diagnostic accuracy.
• Clinicians must maintain critical thinking and avoid premature diagnostic closure, even when influenced by patient statements.
• Educational strategies for both patients and healthcare providers may be needed to address this source of diagnostic error.