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Related Concept Videos

Pulse rhythm01:30

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
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Related Experiment Video

Updated: Feb 28, 2026

Real-Time Monitoring of Neurocritical Patients with Diffuse Optical Spectroscopies
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Monitoring the Diagnostic Process on an Inpatient Neurology Service.

Amar Dhand1, Robert Bucelli2, Arun Varadhachary2

  • 1Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

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|June 22, 2017
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Summary

A new tool helps clinicians track their diagnostic process, showing it varies by disease. This system promotes practice reflection and improves healthcare safety.

Keywords:
clinical decision-makingdiagnosisprocess assessment

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Area of Science:

  • Medical Informatics
  • Clinical Decision Making
  • Healthcare Quality Improvement

Background:

  • The Institute of Medicine highlighted the need for monitoring physicians' diagnostic processes.
  • Existing methods for tracking diagnostic reasoning are limited.
  • Developing tools for self-assessment can enhance diagnostic accuracy.

Purpose of the Study:

  • To develop and evaluate a web-based tool for clinicians to record and analyze their diagnostic process.
  • To assess the feasibility and utility of a clinician-driven diagnostic monitoring system.
  • To characterize the diagnostic process for common inpatient neurological disorders.

Main Methods:

  • A secure web application was developed for structured grading of diagnostic data impact.
  • Four neurohospitalists utilized the tool for 6.5 months on a neurology ward.
  • Process measures included diagnoses entered, time per entry, and diagnostic concordance with medical records.

Main Results:

  • Clinicians entered 254 diagnoses, averaging 3 minutes per patient.
  • Diagnoses in the tool agreed with 92% of medical record diagnoses, exceeding billing code agreement (74%).
  • Diagnostic processes varied, with disorders showing clinical, laboratory, or neuroimaging dominance.

Conclusions:

  • A clinician-driven diagnostic process monitoring system is feasible.
  • The tool provides preliminary insights into diagnostic patterns for common disorders.
  • Tracking diagnostic processes can foster clinical reflection and improve patient safety.