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Laura Zwaan Senior researcher

l.zwaan@erasmusmc.nl

Clinical reasoning

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Research

I study diagnostic reasoning processes and diagnostic errors in medicine using a variety of research methods. My current research projects involve studies to identify weaknesses in the diagnostic process and studies that identify and test educational strategies that can help prevent diagnostic errors. Furthermore, I systematically identify the research priorities for the field of diagnostic safety from both the researcher and patient perspective.

Methods that I use involve patient record reviews, interviews with clinicians about their diagnostic decisions, analysis of malpractice claims and judgements from the disciplinary board. I also conduct experimental studies in which eye-movements of physicians (internists and radiologists) are measured while they are diagnosing case descriptions or viewing X-rays.

 

For a long time diagnostic errors were overlooked in the field of patient safety. I am proud that I initiated and chaired the first European conference on Diagnostic Error in Medicine in Rotterdam in 2016. It was a great success and created much awareness for the topic in Europe.

In the last few years, attention for diagnostic errors has increased. Consequently, more diagnostic error related research is conducted. To make sure research focuses on the right topics, and contributes to diagnostic error reduction, I was invited to lead a research project to identify the research priorities for the field. Using a systematic approach and with the input of many researchers and stakeholders, research priorities were identified. I am proud of this important step for the field.

Despite the high quality healthcare we have in the Netherlands, many patients are harmed by diagnostic errors every year. There is still so much to gain from understanding and improving the diagnostic process. The diagnostic process is fascinating because clinicians have the ability to quickly diagnose patients correctly in very complex settings. On the other hand, the complexity makes the diagnostic process error prone. It is I my goal to contribute to diagnostic error reduction by conducting research, teaching about diagnostic error and creating awareness for the topic of diagnostic error.

I have expertise with measurement of diagnostic error. I understand the complexity of the diagnostic process and have insights into the strengths and limitations of the different research methods and data sources that are used to study diagnostic reasoning and diagnostic errors. In addition, I understand the problem of diagnostic error in healthcare very well. I have insights into the current burden of the problem, the factors that contribute to diagnostic error as well as promising ways to reduce diagnostic errors.