Faulty Information Processing Research Articles

The 6C model for accurately capturing the patient's medical history.

Diagnostic errors are an internationally recognized patient safety concern, and leading causes are faulty data gathering and faulty information processing. Obtaining a full and accurate history from the patient is the foundation for timely and accurate diagnosis. A key concept underlying ideal history acquisition is "history clarification," meaning that the history is clarified to be depicted as clearly as a video, with the chronology being accurately reproduced. A novel approach is presented to improve history-taking, involving six dimensions: Courtesy, Control, Compassion, Curiosity, Clear mind, and Concentration, the '6C's'. We report a case that illustrates how the 6C approach can improve diagnosis, especially in relation to artificial intelligence tools that assist with differential diagnosis.

Depression on a Screen. “The Love Song of J. Alfred Prufrock” in the Light of Cognitive Theories of Depression

This article analyses “The Love Song of J. Alfred Prufrock” in the light of the American psychiatrist A. T. Beck’s diagnostic criteria and cognitive theories for interpreting and evaluating symptoms and levels of depression. This study aims to show that many symptoms listed in Beck’s Inventory for Measuring Depression (sixteen out of twenty-one) are recognizable – at different levels of signifier and signified – in both the poetical structure and the imagery of the poem, whereas specific aspects included in Cognitive Therapy of Depression (for instance, the cognitive process defined by Beck as “Faulty Information Processing” and two crucial points of this process, “Selective abstraction” and “Arbitrary inference”) are identifiable in some of the most relevant figurative isotopies of the poem.

Mind the overlap: how system problems contribute to cognitive failure and diagnostic errors.

Abstract Background Traditionally, research has examined systems- and cognitive-based sources of diagnostic error as individual entities. However, half of all errors have origins in both domains. Methods We conducted a focused ethnography of inpatient physicians at two academic institutions to understand how systems-based problems contribute to cognitive errors in diagnosis. Medicine teams were observed on rounds and during post-round work after which interviews were conducted. Field notes related to the diagnostic process and the work system were recorded, and findings were organized into themes. Using deductive content analysis, themes were categorized based on a published taxonomy to link systems-based contributions and cognitive errors such as faulty data gathering, information processing, data verification and errors associated with multiple domains. Results Observations, focus groups and interviews of 10 teams were conducted between January 2016 and April 2017. The following themes were identified: (1) challenges with interdisciplinary communication and communication within the electronic medical record (EMR) contributed to faulty data gathering; (2) organizational structures such as the operation of consulting services in silos promoted faulty information processing; (3) care handoffs led to faulty data verification and (4) interruptions, time constraints and a cluttered physical environment negatively influenced multiple cognitive domains. Conclusions Systems-based factors often facilitate and promote cognitive problems in diagnosis. Linking systems-based contributions to downstream cognitive impacts and intervening on both in tandem may help prevent diagnostic errors.

Network Structure and Function in Parkinson's Disease.

Little is known of the structural and functional properties of abnormal brain networks associated with neurological disorders. We used a social network approach to characterize the properties of the Parkinson's disease (PD) metabolic topography in 4 independent patient samples and in an experimental non-human primate model. The PD network exhibited distinct features. Dense, mutually facilitating functional connections linked the putamen, globus pallidus, and thalamus to form a metabolically active core. The periphery was formed by weaker connections linking less active cortical regions. Notably, the network contained a separate module defined by interconnected, metabolically active nodes in the cerebellum, pons, frontal cortex, and limbic regions. Exaggeration of the small-world property was a consistent feature of disease networks in parkinsonian humans and in the non-human primate model; this abnormality was only partly corrected by dopaminergic treatment. The findings point to disease-related alterations in network structure and function as the basis for faulty information processing in this disorder.

Using voluntary reports from physicians to learn from diagnostic errors in emergency medicine

ObjectivesDiagnostic errors are common in the emergency department (ED), but few studies have comprehensively evaluated their types and origins. We analysed incidents reported by ED physicians to determine disease conditions,...

Cognitive Error Questionnaire (CEQ): Psychometric Properties and Factor Structure of the German Translation

A central component of Beck et al.’s (1979) cognitive theory of depression is faulty information processing reflected by so-called cognitive errors. These cognitive errors are the reason why depressed individuals systematically misinterpret the significance of events in a negative way. They are usually assessed with the application of the Cognitive Error Questionnaire (CEQ). This study examines the psychometric properties and factor structure of the German version of the CEQ in a sample of 796 volunteers at a German university. Results confirmed that the German CEQ has satisfactory to very good psychometric properties, like the American original. Confirmatory factor analyses demonstrated that a hierarchical four-factor model with four subscales and 1 s order factor fits the data best. Therefore, besides using the German CEQ in studies with German-speaking samples, the similarities in psychometric properties of the American and German CEQ allow for cross-cultural studies.

Assessment of Workload Using NASA Task Load Index in Perianesthesia Nursing

According to the Institute of Medicine (IOM), as many as 44,000 to 98,000 people in the United States die in hospitals every year due to medical errors. Multiple physiological and psychological factors can impact the health care provider's attention span, making medical errors more likely. Some of these factors include increased workload, fatigue, cognitive overload, ineffective interpersonal communications, and faulty information processing. Postanesthesia nurses, responsible for providing care to unstable patients emerging from anesthesia with multiple life-threatening conditions, must make critical decisions on a minute-by-minute basis. The current ASPAN Patient Classification/Recommended Staffing Guidelines does not adequately take into account varying care requirements among the patients. If a tool could be found that effectively evaluated staff's workload, ongoing assessment would be enhanced and resources better used. The National Aeronautics and Space Administration-Task Load Index (NASA-TLX), a multifaceted tool for evaluating perceptual (subjective) workload, has seen extensive applications and is widely regarded as the strongest tool available for reporting perceptions of workload. This article will survey various uses of the NASA-TLX and consider the potential uses for this tool in perianesthesia nursing.

Representations of health risks: What social psychology can offer health promotion

This paper proposes that health promotion may benefit from a social psychological theory that maps the contents and evolution of lay `logic'. Social representations theory forms the focus, since it facilitates entry into people's meaning systems regarding risks, as well as into the functions served by such meanings. The theory is assessed once the assumptions of the more commonly used, contrasting perspective of risk perception is examined. Cognitive theories of risk perception tend to focus on an ideal of rational information processing and assume that people are averse to harm. They are unified in their centre of attention being the intrapersonal level. Having looked at studies of lay responses to childhood vaccination, diabetes and smoking, the paper demonstrates that such assumptions can be challenged. Social representations theory is summoned as a unifying rubric in which to conduct studies that operate from wholly different assumptions: the history and symbols held dear within particular social networks fashion their representations of the health issues they face. These are difficult to change because they serve an identity protective function, rather than being products of faulty information processing which can be rectified by way of a dose of'reality'. However, at least by mapping the evolution and contents of such representations one can help health promoters in starting with where audiences are located, rather than operating from models of behaviour change that are underpinned by assumptions that have limited validity.

Schizotypy and leadership: a contrasting model for deficit symptoms, and a possible therapeutic role for sex hormones

Associational loosening, slow and faulty information processing, poor gating of irrelevant stimuli, poor ability to shift attention, poor working memory, passivity, ambivalence, anhedonia, and impaired motor coordination are cardinal features of schizophrenia but, unlike delusions and hallucinations, they are related more to negative/deficit symptoms. As summarized by Bass, numerous studies have correlated leadership with ‘ambition, initiative and persistence’ (opposite of passivity), ‘speed and accuracy of thought’, ‘finality of decision,’ or decisiveness (the opposite of ambivalence), ‘mood control, optimism and sense of humor’ (opposite of anhedonia), etc. Andreasen et al postulate that a disruption in the circuitry among nodes located in the prefrontal regions, the thalamic nuclei, and the cerebellum produces ‘cognitive dysmetria’, meaning difficulty in prioritizing, coordinating, and responding to information, and that it can account for the broad diversity of symptoms of schizophrenia. A relationship between cognitive processes and cerebellar and basal ganglia functions, and a role of neocerebellum in rapidly shifting attention, have been demonstrated. The cognitive styles, including a proficiency to quickly shift attention, of several famous leaders are used as examples of this contrasting model. Julius Caesar and Napoleon, for instance, could dictate to up to six secretaries simultaneously, using their exceptional working memories, and proficiency in quickly and effortlessly shifting attention while flawlessly gating irrelevant external and internal stimuli. It is suggested that specific brain imaging studies could illustrate this contrast. Gray et al noted positive correlations between ‘dominance’, an important leadership trait, and serum levels of dehydroepiandrosterone (DHEA) and testosterone (T), but not of more potent dihydrotestosterone (DHT), in over 1700 older men. Though not scientifically rigorous, the author noted positive correlations (P = 0.0162) between the self-rated ratings of voice depth (promoted by T) and of leadership, but none between those of body hair (DHT dependent) and of leadership in 47 male US National Academy of Sciences members. And 43 male US Senators had deeper voices than 36 male House members (P< 0.01) who, in turn, had deeper voices than either of two groups (numbers 102 and 72) of male scientists (P< 0.01). Therapeutically, before chlorpromazine, DHEA had been used in young schizophrenics with modest success in improving deficit symptoms. DHEA, or other sex hormones, or some of their natural and synthetic derivatives may prove to be valuable to treat deficit symptoms of schizophrenia in both sexes.

Abnormal Information Processing Systems in PTSD

Patients with posttraumatic stress disorder (PTSD) have problems in learning and in retrieving nontraumatic memories and with over-learned traumatic memories. These imaging studies comparing veterans with and without combat-related PTSD suggest that faulty information processing, possibly related to an imbalance between arousal systems and other stress-response systems, may underlie the symptoms. In the first study, 20 Vietnam combat veterans …

DIFFERENT KINDS AND ROLES OF ENVIRONMENTAL UNCERTAINTY

In environmental psychology different roles appears to be ascribed to the concept of environmental uncertainty: in environmental aesthetics optimization of environmental uncertainty is assumed to explain preferences, in environmental-stress research minimization of environmental uncertainty is assumed to reduce stress, and in research on resource dilemmas environmental uncertainty is assumed to be accurately monitored. An analysis of the different definitions in each area of research reveals that environmental uncertainty refers to both event–event and response–consequence covariation, that it is not assumed to be inherent but to relate to ignorance or faulty information processing, and that it is multifacet subsuming the concepts of probability, vagueness and ambiguity. Although the different research areas do not seem to differ importantly in their definitions of environmental uncertainty, there are differences in emphasis. A possible reconciliation rests on: (1) that in research on resource dilemmas it is incorrect that people accurately monitor environmental uncertainty but, in fact, are susceptible to a desirability bias; (2) that sensation seeking plays a role for risk taking in resource dilemmas; and (3) that in environmental-stress research conditions of high environmental uncertainty have primarily been investigated, thus leaving out conditions when an increase of uncertainty would be desirable. It may be concluded then that basically people are optimizers of environmental uncertainty. However, this does not rule out that they, under most of the prevailing conditions, want to reduce environmental uncertainty. To help them do that seems, therefore, more appropriate than to do the reverse.@ 1998 Academic Press