Diagnostic errors can occur when doctors aren't "calibrated" to make the right decisions.
Factors such as how confident the physician is in diagnostics and the health of his or her patient population impact callibration, writes Adam S. Cifu, M.D, an internist and professor of medicine at the University of Chicago, in a column for the Journal of the American Medical Association.
For example, a physician who treats patients who are generally healthy may be less likely to order certain tests or look into certain conditions because he or she is predisposed to thinking such tests are unnecessary.
Physicians who are overconfident in their diagnostic skills, meanwhile, could underestimate a patient's concerns, while a doctor with a low level of confidence may order more tests in search of a diagnosis, Cifu writes.
Dynamic factors can also impact a physician's diagnostic calibration. Stress, exhaustion and burnout can play a role in diagnostic decision-making (a tired doctor may find it harder to reason through a patient's concern, Cifu says), and patients themselves represent a dynamic element in diagnostics, since patients each have individual tolerances for risk.
According to Cifu, current efforts to reduce diagnostic errors must take these factors into account.
"Interventions should also acknowledge and address the role that physician calibration plays in diagnostic error such as considering standards for diagnostic testing and determining the best way of recalibrating the practice of physicians whose rates vary based on these standards," he writes.
That entails gathering more data on patient concerns, satisfaction and outcomes. Physician assessments can also measure some of the factors that can play a role in diagnostic calibration to determine ways to improve diagnostics, he adds.