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Physicians ignore patients' red flags

Physicians may ignore a patient's contextual information, such as their transportation needs, economic situation, or caretaker duties, which can lead to clinical errors, according to a study published in the July 20 issue of Annals of Internal Medicine.

In contrast to biomedical errors, which are not patient-specific, contextual errors represent a failure to individualize care, according to researchers from the University of Illinois at Chicago. They sent study participants posing as patients, who were trained to present variants of four scenarios, to 111 internal medicine attending physicians over two years. Each patient presented a contextual and a biomedical red flag. Responses to probing about flags varied in whether they revealed an underlying complicating biomedical or contextual factor (or both) that would lead to errors in management if overlooked.

Physicians probed fewer contextual red flags (51 percent) than biomedical red flags (63 percent). Error-free care was provided in 73 percent of the uncomplicated encounters, 38 percent of the biomedically complicated encounters, 22 percent of the contextually complicated encounters, and 9 percent of the combined biomedically and contextually complicated patient encounters.

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