Effects of the quality of medical history taking on diagnostic accuracy

Diagnostic errors are a relevant health-care problem. Although medical history taking is usually the first step in patients’ assessment there only limited data on association of its quality and diagnostic accuracy. Accordingly, this prospective randomized simulator-based single-blind trial aimed to investigate effects initial cues skills 198 students (135 females) were given task assess patient presenting with simulated acute pulmonary embolism. Participants six versions scenario differing cues, i.e., reply question about reason for his visit. In three versions, restricted thoracic symptoms (chest pain, dyspnoea, or combination both). remaining consisted extra-thoracic (leg immobilization) symptoms. The primary outcome was number unrelated However, resulted higher accuracy than (52/96 vs. 35/102, p = 0.006). multivariate regression, questions asked from categories “risk factors embolism” (regression coefficient 0.15, < 0.001) “dyspnea” 0.12, predicted Moreover, relating “immobilization” 0.42, 0.001), “onset dyspnea” 0.23, 0.003), “modifying chest pain” 0.20, 0.04) independently Interestingly, more systematic associated lower −0.27, 0.001). present demonstrates that during initially revealed by patient, kind category interview, interview’s structural systematics affect