Behind heart disease and cancer, medical error is now listed as one of the leading causes of death. Of the many medical errors that may lead to injury and death, diagnostic failure is regarded as the most significant. Generally, the majority of diagnostic failures are attributed to the clinicians directly involved with the patient, and to a lesser extent, the system in which they work. In turn, the majority of errors made by clinicians are due to decision making failures manifested by various departures from rationality. Of all the medical environments in which patients are seen and diagnosed, the emergency department is the most challenging. It has been described as a "wicked" environment where illness and disease may range from minor ailments and complaints to severe, life-threatening disorders. The Cognitive Autopsy is a novel strategy towards understanding medical error and diagnostic failure in 42 clinical cases with which the author was directly involved or became aware of at the time. Essentially, it describes a cognitive approach towards root cause analysis of medical adverse events or near misses. Whereas root cause analysis typically focuses on the observable and measurable aspects of adverse events, the cognitive autopsy attempts to identify covert cognitive processes that may have contributed to outcomes. In this clinical setting, no cognitive process is directly observable but must be inferred from the behavior of the individual clinician. The book illustrates unequivocally that chief among these cognitive processes are cognitive biases and other flaws in decision making, rather than knowledge deficits.

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

This case-based book illustrates and explores common cognitive biases and their consequences in the practice of medicine. The book begins with an introduction that explains the concept of cognitive errors and their importance in clinical medicine and current controversies within healthcare. The core of the book features chapters dedicated to particular cognitive biases; cases are presented and followed by a discussion of the clinician's rationale and an overview of the particular cognitive bias. Engaging and easy to read, this text provides strategies on minimizing cognitive errors in various medical and professional settings.

This book exposes the dangerously imperfect forensic evidence that we rely on for criminal convictions. "That's not my fingerprint, your honor," said the defendant, after FBI experts reported a "100-percent identification." The FBI was wrong. It is shocking how often they are. Autopsy of a Crime Lab is the first book to catalog the sources of error and the faulty science behind a range of well-known forensic evidence, from fingerprints and firearms to forensic algorithms. In this devastating forensic takedown, noted legal expert Brandon L. Garrett poses the questions that should be asked in courtrooms every day: Where are the studies that validate the basic premises of widely accepted techniques such as fingerprinting? How can experts testify with 100-percent certainty about a fingerprint, when there is no such thing as a 100 percent match? Where is the quality control at the crime scenes and in the laboratories? Should we so readily adopt powerful new technologies like facial recognition software and rapid DNA machines? And why have judges been so reluctant to consider the weaknesses of so many long-accepted methods? Taking us into the lives of the wrongfully convicted or nearly convicted, into crime labs rocked by scandal, and onto the front lines of promising reform efforts driven by professionals and researchers alike, Autopsy of a Crime Lab illustrates the persistence and perniciousness of shaky science and its well-meaning practitioners.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

The Psychology of Death Investigations outlines definitively how behavioral evidence can often provide the necessary components and "missing pieces" to complement physical evidence as an essential tool for incident reconstruction. In order to determine the direction of an investigation and to prioritize leads, if necessary, death investigators must establish the manner of a death: natural, accident, homicide or suicide. The most overlooked aspect of death investigation is the psychological dimension, which can provide unique leads, correct false assumptions, enhance investigative awareness, and solve cases in surprising ways. In an estimated 10–20% of cases, the manner of death cannot be determined, or worse, has been erroneously categorized. Since many jurisdictions can’t afford behavioral consultants, this book has been written to provide practical information for a basic psychological analysis. If the circumstances surrounding a death are equivocal, psychological consultants can compile information retrospectively about a deceased person’s mental state and possible motive to assist with unravelling ambiguity about the manner of death. This is the primary function of a psychological autopsy, and, as such, this is the first book of its kind dedicated solely to the topic. In the event that the manner of death is determined to be a homicide, behavioral profiling can help to focus the potential pool of suspects. Professionals and students alike will benefit from the exercise of cognitive awareness and the application of psychological logic presented. Psychologists, medical examiners, coroners, attorneys, fraud examiners, law enforcement personnel, death and homicide investigators, and students enrolled in criminal profiling, forensic psychology, and criminal justice programs will find this text to be a compelling and insightful reference to add to their professional toolkit.

Keep your brain young, healthy, and sharp with this science-driven guide to protecting your mind from decline by neurosurgeon and CNN chief medical correspondent Dr. Sanjay Gupta. Throughout our life, we look for ways to keep our minds sharp and effortlessly productive. Now, globetrotting neurosurgeon Dr. Sanjay Gupta offers “the book all of us need, young and old” (Walter Isaacson, #1 New York Times bestselling author of The Code Breaker) with insights from top scientists all over the world, whose cutting-edge research can help you heighten and protect brain function and maintain cognitive health at any age. Keep Sharp debunks common myths about aging and mental decline, explores whether there’s a “best” diet or exercise regimen for the brain, and explains whether it’s healthier to play video games that test memory and processing speed, or to engage in more social interaction. Discover what we can learn from “super-brained” people who are in their eighties and nineties with no signs of slowing down—and whether there are truly any benefits to drugs, supplements, and vitamins. Dr. Gupta also addresses brain disease, particularly Alzheimer’s, answers all your questions about the signs and symptoms, and shows how to ward against it and stay healthy while caring for a partner in cognitive decline. He likewise provides you with a personalized twelve-week program featuring practical strategies to strengthen your brain every day. Keep Sharp is the “must-read owner’s manual” (Arianna Huffington) you’ll need to keep your brain young and healthy regardless of your age!

Shneidman (U. of California at Los Angeles) examines the case of an individual suicide, bringing together interviews with his family and friends, involved professionals, and "consultations" with other psychiatrists specializing in suicide in order to conduct a post-mortem "autopsy" of the psychological state that led to the young man's death

Despite diagnosis being the key feature of a physician's clinical performance, this is the first book that deals specifically with the topic. In recent years, however, considerable interest has been shown in this area and significant developments have occurred in two main areas: a) an awareness and increasing understanding of the critical role of clinical decision making in the process of diagnosis, and of the multiple factors that impact it, and b) a similar appreciation of the role of the healthcare system in supporting clinicians in their efforts to make accurate diagnoses. Although medicine has seen major gains in knowledge and technology over the last few decades, there is a consensus that the diagnostic failure rate remains in the order of 10-15%. This book provides an overview of the major issues in this area, in particular focusing on where the diagnostic process fails, and where improvements might be made.

With the increased emphasis on reducing medical errors in an emergency setting, this book will focus on patient safety within the emergency department, where preventable medical errors often occur. The book will provide both an overview of patient safety within health care—the 'culture of safety,' importance of teamwork, organizational change—and specific guidelines on issues such as medication safety, procedural complications, and clinician fatigue, to ensure quality care in the ED. Special sections discuss ED design, medication safety, and awareness of the 'culture of safety.'