Calibrating how doctors think and seek information to minimise errors in diagnosis

Information gathering is a foundational step of the diagnostic process.1 It is not possible to synthesise clinical information to make a correct diagnosis without adequate data collection related to a patient's history, physical examination, test results or consultations with other clinicians. However, evidence over the last several decades suggests that failures in information gathering are common and feature prominently in analyses of diagnostic errors.2–7 Many information-gathering failures are related to history taking, including asking the right questions, which is sometimes based on certain cues from the patient.

In this issue of BMJ Quality and Safety, Sheringham et al8 used simulated patient vignettes to understand the role that patient characteristics (including demographics and symptomatology) play in physicians' decisions to investigate for possible diagnosis of lung cancer. They found that despite suggestive initial symptoms, general...

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