Visual perception, cognition, and error in dermatologic diagnosis: Key cognitive principles
Visual perception, cognition, and error in dermatologic diagnosis: Key cognitive principles
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DOI：
10.1016/j.jaad.2018.10.082
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发表时间：
2019-12-01
影响因子：
13.8
通讯作者：
Lowenstein, Eve J.
中科院分区：
文献类型：
--
作者：
Ko, Christine J.;Braverman, Irwin;Lowenstein, Eve J.
皮肤科诊断主要依靠视觉，其次是听觉和语言输入。准确的皮肤诊断是基于看到和感知皮肤发现，正确地分类和命名发现，并将视觉数据和从临床遇到的总体数据（即从其他感官模式）获得的数据与皮肤诊断的工作心理数据库进行比较。基本假设是错误的，即皮肤科医生是上述每一个步骤的专家，并且在它们之间无缝地、无差错地依次转换。这些步骤中的每一个都有固有的挑战，步骤之间的转换也可能有问题。在这个由两部分组成的报告的第1部分中，我们描述了与视觉识别相关的陷阱。在第2部分，我们讨论认知启发式，因为他们涉及到皮肤科诊断过程和诊断错误的预防。
Dermatologic diagnosis relies on vision primarily and auditory and verbal input secondarily. Accurate dermatologic diagnosis is predicated on seeing and perceiving a skin finding, categorizing and naming the finding correctly, and comparing the visual data and data obtained from the totality of the clinical encounter (ie, from other sensory modalities) with one's working mental database of dermatologic diagnoses. The baseline assumption-which is false-is that a dermatologist is an expert at each of the aforementioned steps and transitions sequentially between them seamlessly in an error-free fashion. Each of these steps has inherent challenges, and the transitions between steps can also be problematic. In part 1 of this 2-part report, we describe the pitfalls associated with visual recognition. In part 2, we discuss cognitive heuristics as they relate to the dermatologic diagnostic process and prevention of diagnostic error.