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Physicians may not be accurate in their confidence levels of their diagnoses, says Pitt study

PITTSBURGH, March 29 Physicians' often do not have correct perceptions of the accuracy of their diagnoses at the time they make them, and in significant numbers of cases they may be overconfident--wrong when they believe they are right; or underconfident--right when they believe they are wrong--about their diagnostic assessments, according to a University of Pittsburgh study.

"An overconfident physician will not seek help or may ignore help that is offered; someone underconfident may, in extreme cases, be talked out of what was an accurate assessment," said Charles P. Friedman, Ph.D., professor of medicine at the University of Pittsburgh School of Medicine, in an article published in the April issue of the Journal of General Internal Medicine. Dr. Friedman reported that confidence plays a major role in clinicians' use of outside resources in determining diagnoses and making other medical decisions. These resources include colleagues, medical books, journals and computer-based decision support systems (DSSs).

"Decision support occurs in two modes: either clinicians must seek medical information to supplement what they already know, or if it is 'pushed' to them in the form of a computer-generated alert or reminder, they must be open to the advice," Dr. Friedman said.

"The whole decision support process presupposes that clinicians know when to seek help or pay attention to help that is offered," he said, noting that this study is not about how often physicians are correct, but rather, when they are correct, whether they are aware of it.

"Dr. Friedman, who is on leave from Pitt to work as a senior scholar and program officer in the National Library of Medicine at the National Institutes of Health in Bethesda, Md., and his colleagues developed detailed written synopses from 36 detailed diagnostically challenging cases from patient records at the University of Illinois at Chicago, the University of Michigan and the University of North C
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29-Mar-2005


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