Isabel Healthcare

	Diagnostic Errors—The Next Frontier for Patient Safety. Journal of the American Medical Association, David E. Newman-Toker, MD & Peter J. Pronovost, MD, JAMA, March 11, 2009—Vol 301, No. 10



	Diagnosis Error: Is Overconfidence the Problem? Guest Editors: Mark L. Graber, MD, FACP and Eta S. Berner, EdD, FACMI, FHIMSS. The American Journal of Medicine (2008) Vol 121 (5A), S1.



	View & Download – single (4MB) PDF of Peer Reviewed Articles on Isabel Decision Support Checklists for Diagnosis & Diagnosis Quality

Peer reviewed articles cited in Pubmed

Graber ML, Tompkins D, Holland JJ. Resources medical students use to derive a differential diagnosis. Medical Teacher. 2009, 31(6): 522 - 527.

Thomas NJ, Ramnarayan P, Bell MJ, Maheshwari P, Wilson S, Nazarian EB, Phipps LM, Stockwell DC, Engel M, Maffei FA, Vyas HG, Britto J. An international assessment of a web-based diagnostic tool in critically ill children. Technol Health Care. 2008;16(2):103-10

Graber ML, Mathew A. Performance of a Web-Based Clinical Diagnosis Support System for Internists J Gen Intern Med. 2008 Jan 5; [Epub ahead of print].

Padmanabhan Ramnarayan, Natalie Cronje, Ruth Brown, Rupert Negus, Bill Coode, Philip Moss, Taj Hassan, Wayne Hamer, Joseph Britto. Validation of a diagnostic reminder system in emergency medicine: a multi-centre study. Emergency Medicine Journal 2007;24:619-624; doi:10.1136/emj.2006.044107

Britto J, Ramnarayan P. Google - limited usefulness as a diagnosis reminder system. BMJ 2006. BMJ, doi:10.1136/bmj.39003.640567.AE (published 11 November 2006)

Ramnarayan P, Winrow A, Coren M, Nanduri V, Buchdahl R, Jacobs B, Fisher H, Taylor PM, Wyatt JC, Britto JF. Diagnostic omission errors in acute paediatric practice: impact of a reminder system on decision-making. BMC Med Inform Decis Mak. 2006 Nov 6;6(1):37 [Epub ahead of print]
PMID: 17087835

Ramnarayan P, Roberts GC, Coren M, Nanduri V, Tomlinson A, Taylor PM, Wyatt JC, Britto JF. Assessment of the potential impact of a reminder system on the reduction of diagnostic errors: a quasi-experimental study.BMC Med Inform Decis Mak. 2006 Apr 28;6:22.
PMID: 16646956

Ramnarayan P, Kapoor RR, Coren M, Nanduri V, Tomlinson AL, Taylor PM, Wyatt JC, Britto JF. Measuring the impact of diagnostic decision support on the quality of clinical decision making: development of a reliable and valid composite score. J Am Med Inform Assoc. 2003 Nov-Dec;10(6):563-72. Epub 2003 Aug 4.
PMID: 12925549

Ramnarayan P, Tomlinson A, Britto J, Kulkarni G. Diagnostic decision support in the ED: practical considerations. Emerg Med J. 2005 Jun;22(6):462.
PMID: 15360981

Bavdekar SB, Pawar M. Evaluation of an Internet delivered pediatric diagnosis support system (ISABEL) in a tertiary care center in India. Indian Pediatr 2005 Nov;42(11):1086-91.
PMID:16340049

Ramnarayan P, Tomlinson A, Kulkarni G, Rao A, Britto J. A novel diagnostic aid (ISABEL): development and preliminary evaluation of clinical performance. Medinfo. 2004;11(Pt 2):1091-5.
PMID: 15360981

Britto J. ISABEL at the helm. A web-based diagnosis system speeds clinical decisions for pediatric physicians. Health Manag Technol. 2004 Jul;25(7):28-9.
PMID: 15283508

Fisher H, Tomlinson A, Ramnarayan P, Britto J. ISABEL: support with clinical decision making. Paediatr Nurs. 2003 Sep;15(7):34-5.
PMID: 14533538

Ramnarayan P, Steel E, Britto J. Sharing patient information electronically throughout NHS: ability to provide seamless decision support will be key factor. BMJ. 2003 Sep 13;327(7415):623.
PMID: 12969950

Ramnarayan P, Tomlinson A, Rao A, Coren M, Winrow A, Britto J. ISABEL: a web-based differential diagnostic aid for pediatrics: results from an initial performance evaluation. Arch Dis Child. 2003 May;88(5):408-13.
PMID: 12716712

Ramnarayan P, Britto J. Pediatric clinical decision support systems. Arch Dis Child. 2002 Nov;87(5):361-2.
PMID: 12390900

Greenough A. Help from Isabel for pediatric diagnoses. Lancet. 2002 Oct;360(9341):1259.
PMID:12401291

Thomas NJ. Web report-Isabel. Critical Care 2002 Dec;6(6).

Key medical/nursing articles by the Isabel team

Diagnostic Errors and ISABEL: A Web-Based Diagnostic Reminder System.

University of New Hampshire

March 2009

Janice Vaughn MSN, RN, CNL.

An International Assessment of a Web-based Diagnostic Tool in Critically Ill Children

Technology and Health Care

2007

Neal J Thomas, MD.

Decision Support Systems: A How-To Guide to Their Evaluation

J Int Care Med

June 2005

Ramnarayan P, Britto J.

Computerized Support for Diagnostic Decisions in the Intensive Care Unit

J Int Care Med

Jan 2005

Ramnarayan P, Britto J.


	ISABEL: a novel Internet-delivered clinical decision support system	Healthcare Computing	March 2004

P Ramnarayan, G Kulkarni, A Tomlinson, J Britto.


	Clinical Risk: Isabel: a novel approach to the reduction of medical error.	Clinical Risk	Jan 2004

Ramnarayan P, Steel E, Britto J.

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Schiff, Gordon D. ; Hasan, Omar ; Kim, Seijeoung et al. Diagnostic Error in Medicine: Analysis of 583 Physician-Reported Errors. Archives of Internal Medicine, Nov 2009, 169(20):1881-1887.

Berner, Eta S. Diagnostic Error in Medicine: Introduction. Adv in Health Sci Educ (2009) 14:1-5.

Graber, Mark L. Educational Strategies to Reduce Diagnostic Error: Can you teach this stuff? Adv in Health Sci Educ (2009) 14:63-69.

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	Karen S. Cosby, Rebecca Roberts, Lisa Palivos et al. Characteristics of Patient Care Management Problems Identified in Emergency Department Morbidity and Mortality Investigations During 15 Years.Ann Emerg Med.2008;51:251-261.PMID: 17933430

Graber M.Diagnostic Errors in Medicine: What Do Doctors and Umpires Have in Common? AHRQ Web M&M 2007 Feb.

Gandhi TK, Kachali A et al.Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims. Ann Intern Med. 2006 Oct;145(7):488-96.PMID: 17015866

Annas GJ.The Patient's Right to Safety - Improving the Quality of Care through Litigation against Hospitals. N Engl J Med. 2006 Aug;355(7):735-36.PMID: 16687721

Studdert David M., Mello Michelle M., Gawande Atul A. et al. Claims, Errors, and Compensation Payments in Medical Malpractice Litigation.N Engl J Med; May 2006;354:2024-33.

Schiff GD, Seijeoung K, Abrams R et al.Diagnosing Diagnosis Errors: Lessons from a Multi-institutional Collaborative Project. Advances in Patient Safety 2005 Oct; 2:255-78

				Graber M.Diagnostic error in Internal Medicine. Arch Intern Med. 2005 Jul 11;165(13):1493-9.PMID: 16009864

Friedman C et al.Do Physicians Know When Their Diagnoses Are Correct? Implications for Decision Support and Error Reduction.J Gen Intern Med. 2005 Apr;20(4):334-9.PMID: 15857490

Burroughs TE, Waterman AD, Gallagher TH et al.Patient Concerns about Medical Errors in Emergency Departments. Acad Emerg Med. 2005 Jan;12(1):57-64 .PMID: 15635139

				Aylin P, Tanna S, Bottle A, Jarman B. Medical Error in NHS Hospitals. BMJ. 2004 Aug 14;329(7462):369.PMID: 15310606

	Miller MR, Zhan C. Pediatric patient safety in hospitals: a national picture in 2000. Pediatrics. 2004 Sep;114(3):90.PMID: 15173500

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Kaveh G Shojania, Elizabeth C.Burton et al. Changes in Rates of Autopsy-Detected Diagnostic Errors Over Time. JAMA. 2003 Jun;289(21):2849-56.PMID: 12783916

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George D. Lundberg. 40% Discordance Between What Clinical Physicians Diagnose As Causes Of Death Ante-mortem And What The Postmortem Diagnoses Are.JAMA 1998 Oct 14;280(14):1273-4. PMID: 9786381