How do our minds steer us towards diagnostic mistakes and unfair judgments? This introduction to cognitive bias uses emergency medicine examples to explore anchoring, availability, oversimplification and assumptions about others, while emphasising that recognising bias in ourselves takes practice.
Can a single very low high-sensitivity troponin T result, combined with a non-ischaemic ECG, rule out myocardial infarction? Rick Body discusses a 2016 TRAPID-AMI analysis, its promising diagnostic performance and why excluding infarction does not automatically make discharge appropriate.
One high sensitivity troponin test to rule out acute myocardial infarction Read More
What forces might reshape emergency medicine over the next two decades? This companion to Simon Carley’s 2016 SMACC Dublin presentation introduces three linked discussions of demographics, technology and politics, inviting readers to look beyond today’s clinical workload to the specialty’s future.
The Big Questions in Emergency Medicine. What’s our future? SMACC Dublin Read More
A patient’s chest pain has resolved and the emergency department ECG looks relatively reassuring. This teaching case asks what information might still be missing, using the contrast with an earlier ambulance tracing to explore dynamic ECG changes and the importance of clinical detective work.
Cardiology Case 05: Detective work Read More
Why does a diagnosis seem to appear everywhere just after we learn about it? This exploration of the Baader–Meinhof phenomenon connects selective attention and confirmation bias with history-taking and investigation, asking clinicians to test alternative explanations and seek another perspective when needed.
The Illusion of Frequency. Baader-Meinhof storm St.Emlyn’s Read More
Why do unfinished jobs keep occupying our attention during a busy shift? This introduction to cognitive ‘bandwidth’ explores working memory, interruptions and the Zeigarnik effect, considering how unresolved tasks and growing expertise can influence the mental resources available for emergency care.
Cliffhangers in the ED. St.Emlyn’s Read More
Why might the immediate fear of a missed diagnosis outweigh the less visible harms of unnecessary testing? Simon Carley explores ‘risk proximity’, distinguishing risks to patients from risks to clinicians and asking how their timing can distort decisions in the emergency department.
Emergency medicine, a risky business part 7: Risk proximity Read More
Could a single high-sensitivity troponin I result help rule out acute coronary syndrome at presentation? This 2015 appraisal examines a diagnostic cohort study, distinguishing negative predictive value from sensitivity and asking how the findings fit with ECG interpretation, clinical risk and different patient populations.
JC: High sensitivity Troponin I on presentation. Is it enough to rule out ACS? St.Emlyn’s Read More
