How doctors think: Can we reduce the diagnostic errors by reflecting about them?

How doctors think: Can we reduce the diagnostic errors by reflecting about them?

Jerome Groopman’s bestselling book ‘How Doctors Think’ is about exactly what it means and a bit more, which is how patients can facilitate doctors to think. Doctors are human and are prone to make mistakes. Most of the diagnostic errors result from cognitive / thinking errors rather than technical errors who work under time pressures. Will it be possible for doctors working under such time pressures to think about how they think? There are three cardinal cognitive pitfalls – anchoring, attributing and availability errors. Anchoring is seizing the main presenting symptom and making a snap judgment of a diagnosis. Attributing

Person-centred care, personalised medicine, individualised care and precision medicine: are they all the same?

Person-centred care, personalised medicine, individualised care and precision medicine: are they all the same?

‘As healthcare professionals we talk about personalised care, person-centred care, personalised medicine, individualised care and precision medicine. These have distinct meanings, but are often confused as the same thing. By confusing these terms, the policy makers, researchers, healthcare workers, and the public miscommunicate. Patients and their doctors need the same lexicon, particularly as patients gain access to their digital personal health records. [BMJ Blog by Dr Jane Wilcock – LINK]   Personalised care refers to a wide holistic discussion with the patient, and at times their loved ones, which considers the patient’s context. It requires specific consultation and management skills.

Sodium-glucose cotransport-2 (SGLT2) inhibitors for cardio-renal protective effects – CRENDENCE Trial

Sodium-glucose cotransport-2 (SGLT2) inhibitors for cardio-renal protective effects – CRENDENCE Trial

End-stage renal failure is a common sequelae of type 2 diabetes. ACEI and ARBs are the drugs routinely used for renal protection in diabetes. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a newer class of hypoglycaemic agents that lowers blood glucose in patients with type 2 diabetes by increasing the urinary glucose excretion through the inhibition of SGLT2 in the proximal convoluted tubule where the glucose is reabsorbed. SGLT2 inhibitors reduce the renal threshold of glucose from 180 mg per deciliter (10 mmol per liter) to 40 to 120 mg per deciliter (2 to 7 mmol per liter), thereby effectively lowering blood

Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again

Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again

In his latest book, ‘Deep Medicine’ Dr. Topol describes how medicine is broken today and how artificial intelligence can help make healthcare human again. In an interview with The Guardian, Dr Topol was asked about the review report he did for the NHS-UK. LINK You were commissioned by Jeremy Hunt in 2018 to carry out a review of how the NHS workforce will need to change “to deliver a digital future”. What was the biggest change you recommended? ‘I think the biggest change was to try and accelerate the incorporation of AI to give the gift of time – to get back the

I’ve noticed a change in my colleague’s behaviour. What should I do? BMJ 2019 June

I’ve noticed a change in my colleague’s behaviour. What should I do? BMJ 2019 June

It can be difficult to approach a colleague if you have concerns about their wellbeing because of a change in their behaviour. Abi Rimmer asks experts how best to handle this situation.     Remember a) small gestures make a BIG difference b) Take your doctor hat off c) Don’t be embarrassed to ask Small gestures make a big difference Lucy Warner, chief executive of the NHS Practitioner Health Programme, says, “If you’ve noticed a change, then this situation has probably been around for some time and may already have become a fairly serious problem. Doctors are very good at focusing

1 million Sexually Transmitted Diseases (STI) a DAY in the World – WHO

1 million Sexually Transmitted Diseases (STI) a DAY in the World – WHO

Every day, there are more than 1 million new cases of curable sexually transmitted infections (STIs) among people aged 15-49 years, according to data released today by WHO. This amounts to more than 376 million new cases annually of four infections – chlamydia, gonorrhoea, trichomoniasis, and syphilis. On average, approximately 1 in 25 people globally have at least one of these STIs, according to the latest figures, with some experiencing multiple infections at the same time. STIs are preventable through safe sexual practices, including correct and consistent condom use and sexual health education. LINK https://www.who.int/en/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)   Sri Lanka From 2017

Digital Health

Digital Health

What is Digital Health? “Digital health, or the use of digital technologies for health, has become a salient field of practice for employing routine and innovative forms of information and communications technology (ICT) to address health needs. The term digital health is rooted in eHealth, which is defined as “the use of information and communications technology in support of health and health-related fields”. Mobile health (mHealth) is a subset of eHealth and is defined as “the use of mobile wireless technologies for health”. More recently, the term digital health was introduced as “a broad umbrella term encompassing eHealth (which includes

Hypertension guidelines: how much low?

Hypertension guidelines: how much low?

In an era that that ‘evidence-based medicine’ is facing challenges from many fronts, the benefits of blood pressure control have been shown to decrease morbidity and mortality and increase lifespan. The evidence is strong and there is no disagreement among clinicians and researchers. However, there is considerable uncertainty and debate as to how much reduction is needed in systolic blood pressure among the leading guidelines that look at the same evidence. The JNC 2018, AHA/ACC and now NICE guidelines vary with the recommendations. The page below gives the summary of guidelines available from JNC 8 (2014), ACC/AHA (2107) and ESC/ESH

How to get back from a disaster stricken mind

How to get back from a disaster stricken mind

ප්‍රහාරයෙන් බිඳුණු මනස යළි හදාගන්නේ කොහොමද? පාස්කු ඉරිදා සිදු වූ අමානුෂික ත්‍රස්ත ප්‍රහාරය හේතුවෙන් තුන්සියයකට ආසන්න පිරිසක් මිය ගොස් පන්සියයකට ආසන්න පිරිසක් තුවාල ලැබූහ. මියගියවුන් අතර කුඩා දරුවෝ හතළිස් පහකට ආසන්න පිරිසක් වූහ. තුවාල ලද දරුවන් සංඛ්‍යාවද බොහෝය. නොසිතූ මොහොතක ඇති වූ මේ දැවැන්ත ව්‍යසනය හමුවේ සමාජයේ ලොකු කුඩා කාහටත් දැඩි මානසික කම්පනයක් ඇති වූ බව රහසක් නොවේ. මේ ව්‍යසනයට මුහුණ පෑ එමෙන්ම එය දුටු සමස්තයේ අවසාන බලපෑම ඇති වන්නේ මේ හැම දෙනාගේම මනසටය. මෙයට විසඳුමක් ලෙස සමස්ත සමාජයේ මෙන්ම දරුවන්ගේ මානසික ව්‍යාකූලතා අවම කිරීම උදෙසා කළ යුතු හා කළ හැකි දේ මොනවාදැයි, අපි මනෝ චිකිත්සාව පිළිබඳ මහාචාර්ය අතුල සුමතිපාල