Walking a Tightrope: Balancing the Risk of Diagnostic Error in Inpatient Pediatrics

[摘要] Dual process theory describes 2 opposing systems that affect how we approach decisions.1–6 System I thinking enables us to make quick decisions and requires a limited number of cues and information to reach immediate conclusions. These thought processes are typically effortless, mostly correct, and allow us to function efficiently within day-to-day life; we don’t need to spend any energy thinking about turning the faucet off when the glass is full. System II thinking involves deliberate, rational thought; it is effortful and requires us to be reflective and methodical—it is what we use when thinking through detailed dilemmas.In applying this theory to diagnostic decision-making, clinicians aim to achieve a healthy balance between their fast, intuitive System I thinking and their slow, analytical System II thinking. When we overly rely on System I processes, we become vulnerable to the many cognitive biases that can affect diagnostic accuracy.4–10 On the other hand, when we spend too much time in our System II processes, we end up struggling with routine decisions that require timely answers to meet the needs of a rapid-paced medical environment. In this commentary, we present a case that highlights the dangers associated with overreliance on System I thinking and illustrates some of the factors that can impact our ability to maintain this balance in today’s inpatient climate.A 10-year-old female with a history of obesity presented to the emergency department (ED) with a 1-week history of low-grade fever associated with cough and left-sided …

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob