EuroDem2018
EuroDEM 2018

Welcome

Welcome to the second European Conference on Diagnostic Error in Medicine in Bern, the capital of Switzerland. The conference will be an excellent platform to present the latest research and policy initiatives on diagnostic quality and safety, and to network with international peers active in this field.

This conference will host multi-disciplinary speakers from a range of scientific domains involved in improving diagnosis, including psychology, medical education, clinical and laboratory medicine, human factors engineering, epidemiology, informatics, and quality and safety research.

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The conference is organized in collaboration with Patient Safety Switzerland.

This conference is in English. 

 

Sponsors and Supporters


Mundipharma Medical Basel

 

 


VisualDx

 

 


Isabel

 

 


EBSCO Information Services GmbH Berlin - Germany

 

 


Department of Emergency Medicine, Inselpital University Hospital Bern

 

 

About

Scientific Committee

  David Schwappach, MD, MPH. Patient Safety Switzerland, Zurich, Switzerland
   

Jason Maude. Isabel Healthcare, Haslemere, United Kingdom

   

Juliane Kämmer, PhD. Max Planck Institute for Human Development and Charité University Medicine, Berlin, Germany

   

Laura Zwaan, PhD, Co-Chair. Institute for Medical Education Research, Erasmus Medical Center, Rotterdam, Netherland

   

Maarten ten Berg. Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Netherland

   

Wolf Hautz, MD, MME, Chair. Department of Emergency Medicine, Inselspital University Hospital Bern, Switzerland

Organization

Department of Emergency Medicine, Inselspital University Hospital Bern, Switzerland

Ms. Sascha Fischer
and
BBS Congress GmbH

Abstracts

Hardeep Singh
Safer Systems For Safer Diagnosis: Lessons From a Decade of Research to Help Pave the Road Ahead

This presentation will discuss challenges and opportunities related to understanding and reducing diagnostic error through health system-centric approaches (i.e. focusing more than just what’s in “the doctors head” on broader system-related factors that inevitably influence these thought processes). Topics will include the use of health information technology and data from electronic health records, organizational approaches to measure the problem of diagnostic error, and application of learning health systems approaches to understand and improve diagnosis.



Olga Kostopoulou
Diagnostic Decision Support in General Practice

Missing a serious diagnosis, such as a cancer, is the most important kind of diagnostic error in general practice because it can have the worst consequences for patients: inappropriate or delayed treatment can directly affect survival. I will describe the research that underlay the design of a diagnostic support system for General Practitioners (currently in prototype form), and how it was evaluated in different studies in both low and high-fidelity simulations. I will also discuss GPs’ and patients’ attitudes to diagnostic support and possible ways to improve acceptance of external aids by decision makers.



Sue Sheridan

Diagnostic Error from a Patient Perspective

The presentation, “Diagnostic error from a patient perspective” offers an overview of 2 cases studies of diagnostic error through the lens of a mother and widow who has partnered with the healthcare system to prevent harm from missed, wrong and delayed diagnosis. The presentation will map the diagnostic journeys of her son, Cal, and late husband, Pat, onto the National Academy of Medicine’s Diagnostic Process diagram to illustrate the complexities of diagnosis as well as the resultant “what ifs” that patients, clinicians and healthcare systems ask themselves after a diagnostic error that can serve as catalysts for diagnostic improvement efforts.

The presentation will also offer an example of the power of patients partnering with researchers, educators, policy makers, NGOs, public health officials, quality assurance organizations and healthcare systems that resulted in a national change in the standard of care of newborn jaundice management in the USA.

As the Director of Patient Engagement for the Society to Improve Diagnosis in Medicine (SIDM), Sue Sheridan will also share how she is leveraging patient perspectives to improve all facets of SIDM’s diagnostic improvement efforts.



Marie-Claude Audetat/Mathieu Nendaz, WS1
Diagnosing and Remediating Diagnostic Error in Residency Education

Between 5% and 15% of medical students and residents suffer from academic difficulties; unfortunately, these difficulties are often recognized late in the learners’ course of study and training, usually when problems arise in clinical rotations.

Studies on diagnostic errors and difficulties, at undergraduate and postgraduate levels, indicate that a majority of errors include a cognitive component.

According to Graber et al. (2005), the majority of cognitive difficulties are not directly related to a lack of knowledge, but rather to a flaw in data collection, data integration, and data verification.

Limiting a remediation process to the sole knowledge dimension may thus prove insufficient to address reasoning difficulties.

Many studies indicate that delayed or poor identification and remediation of clinical reasoning difficulties can lead to clinician underperformance and can ultimately, risk compromising patient care.

Identifying and delineating concerns early may facilitate timely remediation of problems.
Nevertheless, it may be difficult for teachers to take on this educational role. Another challenge for supervisors is the fact that they only have access to the result of learners’ clinical reasoning process (e.g. the diagnosis or management plan) or to the manifestations of various steps of the process (e.g. how a learner takes a history based on diagnostic hypotheses). Clinical supervisors must therefore possess sufficient understanding of clinical reasoning and strong pedagogical skills to be able to interpret these manifestations and recognize cues of reasoning difficulties. This will enable them not only to rapidly detect and diagnose potential reasoning difficulties but also to articulate their findings to their learners.

This workshop will focus on supervising skills aiming at recognizing and remediating reasoning difficulties which may lead to diagnostic errors in trainees. A taxonomy of the most common clinical reasoning difficulties, (as they present in learners’ patient encounters, case summaries, or chart review) will be presented in this workshop: we will describe the educational process of supporting clinical reasoning and diagnosing clinical reasoning difficulties in the clinical setting.
We will then focus on the management of these difficulties, providing a more detailed description and specific remediation strategies. Participants will be invited to work on how to develop a pedagogical diagnosis and focused remediation strategies. Concrete examples of supervision will be proposed and discussed.



Jason Maude, Gordon Caldwell, Tobias Mueller, WS2
Practical Solutions to Diagnostic Error
Implementing solutions, effecting change

This session aims to provide participants with practical ideas and advice about how to improve diagnostic decision making. The panel includes seasoned practitioners from primary, secondary and tertiary care who will talk about the particular issues they face and solutions they use and have tried.

They will also talk about the all-important cultural issues which often hinder diagnostic improvement initiatives within an institution and how they have tackled them. There will be plenty of time left for questions and discussion.

Learning objectives:

  • Describe possible solutions to improve diagnosis across primary,
    secondary and tertiary care
  • Understand the issues involved with implementing strategies and tools to improve diagnosis


Tobias Mueller, WS2
Diagnostic decission Support in Undiagnosed and Rare Diseases

Dr. Tobais Mueller will give a case based presentation on how computerized diagnostic decission support tools can assist in undiagnosed and rare diseases. State of the art tools will be presented, chances highlighted and limitations discussed.



Paul Epner, Mario Plebani, Cecile Ravesloot, WS3
When diagnostic testing leads to harm

In this session, diagnostic professionals will talk about how errors in the laboratory testing and imaging processes can lead to diagnostic errors, and will discuss the role clinical laboratory specialist and radiologists could fulfill in improving the diagnostic process and in reducing diagnostic harm.

First, Paul Epner, a leader in the field of improving the value of laboratory diagnostics for patients, will present his 5-cause framework for errors in the laboratory testing process, focusing on errors in the pre-pre- and post-post-analytical phases of lab testing (i.e. errors in ordering the right test and correct test interpretation).

Next, Prof. Plebani, (clinical biochemist) a laboratory medicine professional with broad experience in measuring errors in the total laboratory testing process, will present data the frequency and nature of these errors and will discuss how use of quality indicators can contribute to decreasing the incidence of diagnostic errors.

Finally, Dr. Cécile Ravesloot, radiologist, will present her research work on improving image interpretation skill by radiologists by introducing authentic images in assessments.

Learning objectives:

  • To identify the mechanisms by which laboratory medicine can cause diagnostic errors and strategies for mitigating the risk
  • The value of laboratory medicine and how laboratory stewardship will contribute to greater value and to decrease diagnostic errors.
  • How radiology expertise can be stimulated by using authentic images for image interpretation in learning and assessment.


Paul Epner, WS3
An overview on testing-related error

This session describes the mechanism by which clinical laboratory testing can lead to diagnostic error and then illustrates the leading role laboratory physicians and scientists could take to improve the diagnostic process and reduce diagnostic harm. Opportunities for laboratory professionals to deliver value to patients and the care delivery team through an outcomes-oriented approach will also be described as will effective Interventions and practices that can be implemented to shift from being lab-centric to patient-centered clinical laboratories.


Mario Plebani, WS3
Laboratory-Testing Related Error

Over the last decades, more and more timely and accurate laboratory test results have been produced leading the clinical laboratory to be recognized as the “nerve centre of diagnostic process”. Every day, clinical laboratories worldwide analyze billions of samples to provide essential information that allows a reliable clinical decision-making (diagnosis, drugs prescriptions, patients admission/discharge from hospital). However,the complex process that finally provide laboratory information is not error-free. Since 1997, with the publication of the landmark paper by Plebani and Carraro (1), a number of papers demonstrated that errors can occur in any step of the process, in the pre-analytical (46–68.2%), analytical (7–13%) and post-analytical phases (18.5–47%).

Although, compared to billions of laboratory results, the absolute percentage of errors could appear very low, on the contrary, it could become relevant when considered in relation to patient outcome. Although Plebani and Carraro demonstrated that 74% of laboratory errors did not affect patients’ outcome, the other 26% translates into a patient care problem, leading at least to further inappropriate investigations, patient discomfort, increased costs (19%) and, even worse, to inappropriate care and/or modification to therapy (6.4%).

In recent years, a second research path, which has started from the clinical side, demonstrated that errors in laboratory medicine represent a piece of a much wider puzzle that is commonly known as “ diagnostic error ” , definitively linking laboratory-associated errors to patient safety problems.

Recent studies in this area have led to a better understanding of the frequency and nature of diagnostic errors, and their relationship to laboratory testing error. Data on errors in the pre-pre analytical phase (initial procedures performed neither in the clinical laboratory nor, at least in part, under the control of laboratory personnel) underline that failures to order appropriate diagnostic tests, including laboratory tests, accounted for 55% of observed breakdowns in missed and delayed diagnosis in the ambulatory setting and 58% of errors in the Emergency department. In the final steps of the TTP loop, the incorrect interpretation of diagnostic or laboratory tests was found to be responsible for a high percentage of errors in the ambulatory setting as well as in Emergency departments. The search for valuable quality indicators (QIs) for intra- and extra-analytical phases of the testing process and for harmonizing all steps, including test ordering and data interpretation, represents a fundamental issue in projects aiming to improve quality and patient safety.



Cécile Ravesloot, WS3
Diagnostic Error in Radiology

Diagnostic radiology errors have gained more attention in the last decades. The prevalence of errors in diagnostic radiology is not completely known, however in the past, rates up to 30 percent were reported (Garland 1949, Berlin 2014). Till know different strategies did not lower these rates much (Berlin 2007). One of these strategies is to learn from what went wrong. All hospitals in the Western world have by now implemented a workflow to safely report errors, scrutinize the process, learn and make changes to the diagnostic process. Increasing performance in image interpretation by improving training and education is another way of reducing errors, which has received less attention. Consequently not much is known about what radiological expertise implies and how it is developed. Therefore radiology training programs and education differ greatly between institutions and did not change much over the years. This in great contrast with the clinical practice of radiologists which is constantly changing.

Radiological image interpretation can be roughly divided in three components: perception, analysis and diagnosis (Van der Gijp 2014). During perception the observer is occupied with detection of abnormalities, and knowledge on normal anatomical structure plays an important role. Analysis implies in depth observation of features of the abnormalities. In the diagnostic phase a conclusion (diagnosis) or action plan for additional diagnostic tests is made. We know from many studies that there is a large inter- and also intra-observer variability in interpreting radiological images (Berlin 2014, Krupinski 2011). So the obvious question is, what makes a radiologist an expert in image interpretation? Image interpretation is traditionally learned in clinical practice, were residents learn from their supervising radiologists. After becoming a registered radiologist in most European countries no formal education and assessment takes places anymore. The common sense was that experience, amount of images read, automatically led to expertise (Manning 2006). However that does not explain the performance differences between experienced radiologists. Furthermore a study in a Dutch cohort of radiology residents showed that mean knowledge growth levels off at average exam scores of 50% with a large dispersion before the end of training (Ravesloot 2017).

In radiology major improvements in imaging and viewing techniques changed needed skills for radiologists completely in the last 15 years. At the end of the 20th century radiologists were viewing printed single slices of cross sectional imaging techniques like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) hanging next to each (tile viewing). Nowadays all radiological images are digitally viewing and CT and MRI scans, which are often huge volumetric images, can be scrolled through in every possible direction. This is just one of the major changes effecting radiologists’ day-to-day work and different studies showed that the skills for radiological image interpretation changed accordingly. For example, participants interpreting volumetric CT scans were relatively more time occupied with detection of abnormalities in a CT scan than when they were viewing single slices from a CT scan (Van der Gijp 2015). In addition dispersion of scores between high- and low-performers was much larger in assessments with volumetric CT scan than for exams with single slices (Ravesloot 2015a), and in addition volumetric image exams had a better correlation with an external validation measure of volumetric anatomy knowledge (Ravesloot 2015b). Furthermore, in a study of Drew (2013) there appeared to be different strategies of interpretation of volumetric images among radiologists with some evidence that one technique was correlated with better detection rates.
In contrast with the major changes in the viewing task for radiologists, training and education stayed the same for a long time. Students and residents were still trained and assessed with printed single slices most of the time and also no formal training or assessment was given to registered radiologists. Even now new techniques are being implemented in clinical practice without formal training. Also again we are on the brick of major developments with high impact on the radiological imaging process. Artificial intelligence will play a major role in automatic interpretation of images in the near future (Obermeyer 2016). Maybe this will bring us the solution and will cut down error rates finally. However it will never completely take away the interpretation task from humans so we have to keeping improving ourselves and therefore it is essential that education and training keep pace with changing needed skills.



Gerd Gigerenzer
Medical Decisions and Heuristic Reasoning

Diagnostic errors contribute substantially to patient morbidity and mortality. Among the many factors contributing to diagnostic error, cognitive errors of the diagnosing physician have received considerable attention. Many authors have attributed cognitive errors to the use of fast, intuitive thinking and consequentially advocated the implementation of strategies that enforce deliberate considerations. However, the notion of a general superiority of slow analytic thinking in medical decision making has been contested recently. For example, a number of studies correlating diagnostic accuracy with time to diagnosis have found strong inverse relationships, where faster diagnoses were associated with higher quality of diagnoses. Additionally, human “intuition” has evolved well over time and developed a number of mechanisms that work quite well in uncertain and probabilistic environments. A particularly successful approach of strategies neglecting the vast majority of potentially available information and instead focusing on few key characteristics are so called heuristics. After a lifetime of research devoted to heuristic reasoning and information literacy, Gerd Gigerenzer is in a unique position to familiarize the audience with the “fast and frugal” heuristic approach in general and in diagnostic reasoning specifically and contrast his views with extensive research into information literacy of physicians, arguably an important prerequisite for any more “analytic” approach.



Wolfgang Gaissmaier
An Adaptive Toolbox for Diagnostic Decision Making: Smart Heuristics, Social Intelligence and Transparent Representations

Diagnosticians face many aspects of risk and uncertainty when making decisions. They need to understand the benefits and harms of employing diagnostic tests, for instance for the early detection of disease, and they need to be able to understand the meaning of test results. Furthermore, they need to identify patients at risks quickly and, more generally, find the right diagnosis for each patient. None of these tasks is trivial, and the literature has identified various pitfalls and systematic errors. But the decision sciences have also developed methods to support diagnosticians. Importantly, research has shown that there is not one tool to solve all diagnostic tasks, but that diagnostic decision making needs to be an adaptive process where the right decision making tool is applied to the right task. The adaptive toolbox for successful diagnosticians includes transparent representations for understanding statistical information, smart heuristics for dealing with uncertainty, and social intelligence, which is particularly useful when pooling several independent judgments.



Christina Naaktgeboren
To err on the side of uncertainty

The terms overdiagnosis, underdiagnosis, and diagnostic error are increasingly used in many different clinical contexts, with varying definitions and different contributing mechanisms, leading to troublesome communication. A conceptual framework is presented describing the overarching problems surrounding tests into different types of uncertainty and errors. Briefly, uncertainty about whether more good is being done than harm may exist at several critical decision points: who should receive a test, how to precisely define a disease and its subtypes, and how should a condition be managed? Alongside these uncertainties, various errors can occur. This framework assists researchers to think more carefully about the multiple underlying key mechanisms leading to problems jointly labeled as overdiagnosis or underdiagnosis and diagnostic error.



Mirjam Jenny
Machine Learning and Diagnostic Error



Art Papier, Kerstin Ritter, Jason Maude, WS 4
Technical solutions

In this session, experts from the field of machine learning will present the current status of machine learning applications for diagnosis and will illustrate this by presenting state-of-the-art solutions.

First, Dr. Art Papier, will talk about machine learning, clinical decision support and diagnosis.
Next, Dr. Kerstin Ritter will present her research work on using computer-based methods (i.e. machine learning) for supporting radiologists in image interpretations.

Finally, Jason Maude will share his thought on different approaches, e.g. rule-based and machine learning, for differential diagnosis generating software.

Learning objectives:

  • Understand new strategies in visual representation of diagnosis, machine learning and decision support.
  • Learn how computer-based methods can be used to optimize the work of radiologists.
  • Pros and cons of the different ways that differential diagnosis generators and symptom checkers are built.


Art Papier, WS4
Machine Learning of Skin Presentations

We are the beginning of a revolution in machine learning and artificial intelligence. The visual specialties radiology, dermatology, pathology, and ophthalmology are all seeing striking and rapid advances in machine interpretation of images. In dermatology there has been much focus on machine learning for the detection of skin cancer over the past decade. More recently progress has been made in general diagnosis of skin clues by machine learning. In this session we will discuss how machine learning can be integrated into broad diagnostic support, and how visual representation of medical diagnostic complexity enhances both System 1 and System 2 cognition.



Kerstin Ritter, WS4
Machine learning in radiology

Machine learning techniques, including deep learning, seem to have a great potential in reducing diagnostic errors in radiology, After an introduction into different causes of diagnostic errors and key ideas of machine and deep learning, this talk will show several applications in the medical imaging field with a focus on neuroimaging, including own work on multiple sclerosis and different types of dementia. Challenges in using machine learning such as the need for much data and the black box-problem will be discussed.



Jason Maude, WS4
Deep Learning versus Rules Based DDx Generators

With the proliferation of DDx Generators and Symptom Checkers it’s important for clinicians to understand the big differences in how they are built as this determines their capabilities. In this talk we will look at the key methods of construction, some examples and suggest criteria clinicians can use for evaluating them.



Paul Epner WS 5
Using Quality Improvement Techniques to reduce Diagnostic Error

Health care systems are continually involved in quality improvement, but rarely directed at diagnostic error. We are early in the development of effective interventions. In this workshop, we will share case studies of what works, hear the evolution of a collaborative that sought to test some of these interventions, and in a highly interactive session, determine strategies for implementing diagnostic error quality improvement in your clinical setting now.



David Newman-Toker, Workshop 6
Stroke Misdiagnosis

Worldwide, there are more than 15 million strokes annually, roughly one third of which result in death. In the US, stroke is the most commonly missed vascular event and results in both the most malpractice claims and the most total payouts. Strokes are most often missed when symptoms are transient, mild, or non-specific. The symptom most tightly linked to missed stroke in frontline healthcare settings is dizziness/vertigo. Causes appear disproportionately related to misinformation and lack of expertise in bedside assessment. Novel approaches to teamwork, training, technology, and tuning may facilitate timely, accurate diagnosis, thereby preventing serious misdiagnosis-related harms, including permanent disability and death.

Learning Objectives:

  • Describe the clinical contexts in which strokes are most frequently missed and the overall burden of harms.
  • List the principal causes of stroke misdiagnosis, comparing cognitive and systems contributions.
  • Discuss novel solutions to improve stroke diagnosis, leveraging technology and telemedicine.


Yoryos Lyratzopoulos, WS6
Improving the Diagnosis of Cancer: Recent UK Initiatives, Ongoing Research Priorities, Potential Lessons for other Disease Areas and Health Systems

Since 2008, the UK government and major charitable research funders have supported a range of policy initiatives, together with population health and healthcare system research projects, to improve the diagnosis of cancer. These policies, which were prompted by prior epidemiological research documenting unfavourable international comparisons for cancer outcomes in English patients, have since transformed both the evidence base and the configuration of health services and pathways for diagnosing cancer in symptomatic patients. Professor Lyratzopoulos will highlight key achievements in this transformational journey and summarise recent research findings. He will draw out the potential usefulness of UK research and policy to improve the diagnosis of cancer for other disease areas and health systems.

 

Program

Day 1 | Day 2 | Junior Researchers

Download full program PDF.

Thursday, August 30 2018

8.00 - 9.00

Registration

9.00 - 9.15

Welcome and Introduction
Dr. h.c. Uwe E. Jocham, General Manager, Insel Gruppe AG

Mark Graber, MD, FACP, President, Society to Improve Diagnosis in Medicine, Illinois, USA
Prof. Dr. Aristomenis Exadaktylos, Director, Dept. Of Emergency Medicine at Inselspital Bern

9.15 - 10.00

The global Burden of Diagnostic Error
Sir Liam Donaldson, WHO Envoy for patient safety, WHO, Geneva

10.00 - 10.30

Safer Systems For Safer Diagnosis: Lessons From a Decade of Research to Help Pave the Road Ahead
Prof. Dr. Hardeep Singh, MD, MPH, Veterans Affairs Health Services Research Center and Baylor College of Medicine, Houston, USA

30 min.

Coffee break

11.00 - 11.30

Diagnostic Decision Support in General Practice

Prof. Dr. Olga Kostopoulou, Imperial College London, UK

11.30 - 12.00

Diagnostic Error from a Patient Perspective

Sue Sheridan, Director of Patient Engagement, Society to Improve Diagnosis in Medicine, Illinois, USA

12.00 - 12.30

Plenary Poster Pitches (I)

Moderator: Laura Zwaan, PhD, Assistant Professor, Institute for Medical Education Research Rotterdam iMERR, Erasmus MC, The Netherlands

90 min.

Poster viewing & Lunch break

14.00 - 15.30

Oral presentations selected from participant abstracts

30 min.

Coffee break

 

Parallel Workshops & Seminars

16.00 - 17.30

1 Workshop: Diagnosing and Remediating Diagnostic Error in Residency Education
Prof. Dr. Marie-Claude Audetat and Prof. Dr. Mathieu Nendaz, Unité de Développement et de Recherche en Éducation Médicale (UDREM), Université de Genève

2 Workshop: Practical Solutions to Diagnostic Error
Dr. Gordon Caldwell, Consultant Physician, Lorn & Islands Hospital, Oban, UK
Dr. Tobias Mueller
Head of Digital Transformation, Rhön-Klinikum AG, Germany
Jason Maude, CEO & Co-Founder Isabel Healthcare, UK

3 Seminar: When Diagnostic Testing Leads to Harm
Moderator: Maarten ten Berg, PharmD, PhD, University Medical Center Utrecht, The Netherlands
An Overview on Testing-Related Error
Paul Epner, MBA, Chief Executive Officer, Society to Improve Diagnosis in Medicine, Illinois, USA
Laboratory-Testing Related Error
Dr. Mario Plebani, Professor of Clinical Biochemistry and Clinical Molecular Biology, Dean Medical School, University of Padova, Italy
Diagnostic Error in Radiology
Dr. Cecile Ravesloot, MD, PhD, Department of Radiology, Radboud UMC, Nijmegen, The Netherlands

17.30 - 18.00

Plenary poster pitches (II)

Moderator: Laura Zwaan, PhD, Assistant Professor, Institute for Medical Education Research Rotterdam iMERR, MC Erasmus, The Netherlands

18.00 - 18:30

Ask the Expert Session – Interactive Discussion with Presenters from the Day
Moderator: Wolf Hautz, MD, MME, Department of Emergency Medicine, Inselspital Bern

open end

Conference Dinner
Preregistration required, dinner at your own expense. For details please check registration page.


Friday, August 31 2018

8.00 - 9.00

Registration

9.00 - 9.15

Welcome and Announcements
Wolf Hautz, MD, MME, Department of Emergency Medicine, Inselspital Bern

9.15 - 10.00

Medical Decisions and Heuristic Reasoning
Prof. Dr. Gerd Gigerenzer, Director Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin, Germany

10.00 - 10.30

An Adaptive Toolbox for Diagnostic Decision Making: Smart Heuristics, Social Intelligence and Transparent Representations
Prof. Dr. Wolfgang Gaissmaier, Department of Psychology, University of Konstanz, Germany

30 min.

Coffee break

11.00 - 11.30

To err on the side of uncertainty
Christina Naaktgeboren, PhD, University Medical Center Utrecht, The Netherlands

11.30 - 12.00

Plenary poster pitches (clinical cases)
Moderator: Laura Zwaan, PhD, Assistant Professor, Institute for Medical Education Research Rotterdam iMERR, MC Erasmus, The Netherlands

90 min.

Poster viewing & Lunch break

13.30 - 14.00

Machine Learning and Diagnostic error

Dr. Mirjam Jenny, Lead Scientist, Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin, Germany

 

Parallel Workshops & Seminars

14.00 - 15.30

4 Seminar: Technical Solutions
Moderator: Maarten ten Berg, PharmD, PhD, University Medical Center Utrecht, The Netherlands
Machine learning of skin presentations
Art Papier, MD, CEO of VisualDX, Rochester, USA
Machine learning in radiology
Kerstin Ritter, PhD, Charité-Universitätsmedizin Berlin, Germany

Deep Learning versus Rules Based DDx Generators
Jason Maude, CEO & Co-Founder Isabel Healthcare, UK

5 Workshop: Using Quality Improvement Techniques to reduce Diagnostic Error

Paul Epner, MBA, Chief Executive Officer, Society to Improve Diagnosis in Medicine, Illinois, USA

6 Seminar: Disease Specific Presentations
Moderator: Laura Zwaan, PhD, Assistant Professor, Institute for Medical Education Research Rotterdam iMERR, Erasmus MC, The Netherlands
Stroke Misdiagnosis
David Newman-Toker, MD, PhD, Johns Hopkins University, USA
Improving the Diagnosis of Cancer: Recent UK Initiatives, Ongoing Research Priorities, Potential Lessons for other Disease Areas and Health Systems
Georgios Lyratzopoulos, MD, FFPH, FRCP, MPH, DTM&H, Epidemiology of Cancer Healthcare & Outcomes (ECHO) Research Group, University College London, UK
Diagnostic Error in Emergency Medicine
Juliane Kämmer, PhD, Charité Universitätsmedizin Berlin and Max Planck Institute for Human Development, Berlin, Germany & Wolf Hautz, MD, MME, Department of Emergency Medicine, Inselspital Bern

30 min.

Coffee break

16.00 - 16.30

Summing it up: Lessons learned from this conference. Audience response session

Mark Graber, MD, FACP, President, Society to Improve Diagnosis in Medicine, Illinois, USA

16.30 - 17.00

Closing Remarks


Download full program PDF.

 

Junior Researchers

Inviting Junior Researchers Attending DEM Europe to a Special Preconference Session

Are you a researcher Intrigued by the topic of diagnostic error? Want to do a project but overwhelmed with complexity of topic or methods? If yes, then this session is for you.

Diagnostic safety research involves multiple disciplines (e.g. medicine, psychology, and epidemiology) and collaboration is key. In this introductory meeting for junior researchers, we will discuss some opportunities and challenges of studying diagnostic error. We will highlight strengths and limitations of commonly used research methods as well as offer some informal lessons we have learned over the past decade. We will offer tips that might help your research career (e.g. getting your paper published, applying for grants) and as an added plus, you can network with other junior researchers in the field.

Target participants:
Junior researchers (anyone who recently started conducting research on diagnostic safety or is thinking about doing so).

Your hosts:
Laura Zwaan, PhD and Hardeep Singh, MD MPH

When:
Wednesday August 29, 16.00-18.00h followed by a networking dinner.

Where:
Insel Hospital, Bern Switzerland (exact location will follow)

Costs:
The meeting is free of charge if you registered for the DEM conference, but dinner is at your own expense.

Register:
Email to Laura Zwaan (l.zwaan@erasmusmc.nl)

 

Speakers

Marie-Claude Audétat, M.Ps., Ma (Ed), Ph.D., is Associate Professor at the faculty of Medicine, University of Geneva. Since May 2014, she is in charge of the axis of educational research in the Primary Care Unit at the University of Geneva, Switzerland. Ms Audétat is involved in innovative projects regarding clinical reasoning and faculty development in the Unit of Development and Research (UDREM).

She is also Associate Professor in the department of Family and Emergency Medicine at the Université de Montréal, Canada, where she served as Faculty Development Director, from 2010 to 2014.


 

Gordon Caldwell has been a Consultant Physician in the UK since 1993, first at Worthing Hospital in West Sussex, until February 2018 when he moved to the hospital in Oban on the west coast of Scotland. He studied pre-clinical medicine at Worcester College, Oxford University and completed his clinical training at King’s College Hospital Medical School London, qualifying in 1980. Gordon subsequently worked in Brighton, Edinburgh, the Royal Postgraduate Medical School, and Newcastle upon Tyne Hospitals, before taking up his post in Worthing. From early in the 2000s he developed an interest in the organisation of Ward Rounds from the point of view of Quality and Safety of patient care and training of junior doctors for future clinical leadership roles. His interests were kindled further after attending the International Forum on Quality and Safety in Healthcare in early 2009, and in 2010 he published an article in the BMJ on the need for a Diagnostic Cockpit to reduce misdiagnosis, similar to the Sterile Cockpit environment in a commercial plane during takeoff and landing. In UK hospitals most working environments in acute care settings such as Accident and Emergency, the Acute Assessment Units and general wards seem to have developed to the point that they actually enhance misdiagnosis. He has tried to standardise his working processes on ward rounds and has published on the use of a Considerative Checklist to enhance Quality and Safety. Gordon has also published on the inadequacies and unusability of clinical information systems at the patient side. Gordon Calwell lives in a very rural setting and enjoys hill walking and photography.




Paul Epner, MBA, is the Chief Executive Officer and co-founder of the Society to Improve Diagnosis in Medicine (SIDM). He is also the Chair of the Coalition to Improve Diagnosis, a multi-organization collaboration in the U.S.. He serves on the National Steering Committee for Patient Safety and is a Past President of the Clinical Laboratory Management Association (CLMA) where he created the Increasing Clinical Effectiveness (ICE) initiative. In addition to his focus on diagnostic error, Paul has been a thought leader on the role that clinical laboratorians should take to improve patient outcomes and health care delivery effectiveness.




Wolfgang Gaissmaier, PhD, has been a Full Professor of Social Psychology and Decision Sciences at the University of Konstanz, Germany, since 2014. His research investigates how people make decisions under uncertainty and how risks can be communicated more successfully to help people make better decisions, particularly in medicine. Mr Gaissmaier received his PhD in 2007 (Free University Berlin) and his habilitation (venia legendi) in 2013 (University of Heidelberg). For many years, he worked as Chief Research Scientist at the Harding Center for Risk Literacy at the Max Planck Institute for Human Development, Berlin. Wolfgang Gaissmaier’s work has been published in leading psychological and medical journals, including Annals of Internal Medicine, Annual Review of Psychology, Cognition, Health Psychology, JAMA, PNAS, and Psychological Science. He received numerous awards, including the Otto Hahn Medal for outstanding scientific achievements by the Max Planck Society (2008), a fellowship at the Young Academy of the Berlin-Brandenburg Academy of Sciences and Humanities and the German Academy of Sciences Leopoldina (2012-2017), a rising star nomination by the Association for Psychological Science, and an award for excellent teaching and being a positive role model by the students of the University of Konstanz (2016).




Gerd Gigerenzer is Director of the Harding Center for Risk Literacy at the Max Planck Institute for Human Development in Berlin and partner of Simply Rational - The Institute for Decisions. He is former Director of the Adaptive Behavior and Cognition (ABC) Center at the Max Planck Institute for Human Development and at the Max Planck Institute for Psychological Research in Munich, Professor of Psychology at the University of Chicago and John M. Olin Distinguished Visiting Professor, School of Law at the University of Virginia. In addition, he is Member of the Berlin-Brandenburg Academy of Sciences, the German Academy of Sciences and Honorary Member of the American Academy of Arts and Sciences and the American Philosophical Society. He was awarded honorary doctorates from the University of Basel and the Open University of the Netherlands, and is Batten Fellow at the Darden Business School, University of Virginia. Awards for his work include the AAAS Prize for the best article in the behavioral sciences, the Association of American Publishers Prize for the best book in the social and behavioral sciences, the German Psychology Award, and the Communicator Award of the German Research Foundation. His award-winning popular books Calculated Risks, Gut Feelings: The Intelligence of the Unconscious, and Risk Savvy: How to make good decisions have been translated into 21 languages. His academic books include Simple Heuristics That Make Us Smart, Rationality for Mortals, Simply Rational, and Bounded Rationality (with Reinhard Selten, a Nobel Laureate in economics). In Better Doctors, Better Patients, Better Decisions (with Sir Muir Gray) he shows how better informed doctors and patients can improve healthcare while reducing costs. Together with the Bank of England, he is working on the project “Simple heuristics for a safer world.” Gigerenzer has trained U.S. federal judges, German physicians, and top managers in decision making and understanding risks and uncertainties.




Mark L. Graber, MD, FACP, is a Senior Fellow at RTI International, Professor Emeritus of Medicine at the State University of New York at Stony Brook, and President of the Society to Improve Diagnosis in Medicine. Dr Graber is a leader in the field of patient safety and originated the U.S. Patient Safety Awareness Week in 2002, an event now recognized internationally. He is also a pioneer in efforts to address diagnostic errors in medicine. In 2008, he originated the Diagnostic Error in Medicine conference series, in 2011 he founded the Society to Improve Diagnosis and in 2014 he launched a new journal, DIAGNOSIS, devoted to improving the quality and safety of diagnosis, and reducing diagnostic error. Dr Graber received the 2014 John M Eisenberg Award from The Joint Commission and the National Quality Forum, recognizing individual achievement advancing patient safety.




Mirjam Jenny is the head research scientist of the Harding Center for Risk Literacy at the Max Planck Institute for Human Development (MPIB). Her research in decision making and risk literacy is located at the intersection of psychology, computer science, and medicine. Currently, she is developing decision aids for the medical domain, for example, fast and frugal decision trees for emergency medicine and anesthesiology using machine learning methods. Being actively engaged in the German health care landscape she hopes to improve the medical decisions of patients, doctors, and institutions. After receiving her PhD in psychology at the University of Basel, Switzerland, she spent her postdoc at the Center for Adaptive Rationality at the MPIB where she won the Otto Hahn Medal awarded by the Max Planck Society. She then moved into the health care sector and spent one year at the National Association of Statutory Health Insurance Physicians as a data scientist.


 

Juliane Kämmer is a psychologist by training. She received her diploma in 2009 and her PhD in 2013 from the Humboldt University Berlin. Since 2009, she is affiliated with the Max Planck Institute for Human Development in Berlin, first as a Predoc and then as a Postdoc. Currently, she is the Head Research Scientist at the AG Progress Test Medicine at the Charité Medical School Berlin. Ms Kämmer enjoys research at the intersection of psychology, medicine, medical education and computer science. She is interested in medical decision making, particularly diagnostic decision making in the emergency room and the role of teams in the diagnostic process.


 

Olga Kostopoulou is Reader in Medical Decision Making at Imperial College London. Prior to her current position, she held academic appointments at King’s College London (Senior Lecturer) and the University of Birmingham (Lecturer). She holds a first degree, an MSc and a PhD in Psychology. She applies psychology theory and (primarily quantitative) methods to the study of medical decision making. She studies the cognitive parameters that underlie professional medical judgements and decisions, and researches ways to support them. She has had funding from the Department of Health, Cancer Research UK, and the EU. She is Associate Editor of the journal Medical Decision Making, has served as elected Trustee on the Board of SMDM (smdm.org), and has chaired the biennial SMDM European meeting in London (June 2016). She delivers short courses on the psychology of medical decision making to UK and international audiences.




Yoryos (Georgios) Lyratzopoulos, MD, FFPH, FRCP, MPH, DTM&H, is Professor of Cancer Epidemiology and Cancer Research UK Advanced Clinician Scientist Fellow at University College London (UCL). He leads the Epidemiology of Cancer Healthcare and Outcomes (ECHO) Group; and the UCL component of the CanTest Research Collaborative, supported by the inaugural Cancer Research UK Population Health Catalyst award (https://www.cantest.org). He is also part-time affiliated to the University of Cambridge and the Public Health England National Cancer Registration and Analysis Service. His research focuses on the predictors and outcomes of diagnostic timeliness in the diagnostic process for cancer patients who present with symptoms; the evaluation of new diagnostic strategies; and cancer patient experience. Mr Lyratzopoulos was previously National Institute for Health Research (UK) Post-Doctoral Fellow (2012-14) and has worked in the English National Health Service as a hospital doctor (internal medicine) and as a public health physician. He has also worked as clinical adviser to NICE’s interventional Procedures Programme 2006-2011. To June 2017, he has published over 140 peer-reviewed papers, two thirds of which as first/last author http://tinyurl.com/lncqq7f . He was awarded the Cancer Research UK ‘Future Leaders’ Prize in 2016, which recognises individuals who have produced world-leading research during their first 10 post-doctoral years.


 

Jason Maude serves as Chief Executive Officer and Co-founder of Isabel Healthcare Ltd. Prior to co-founding Isabel Healthcare Ltd, Maude spent 12 years working in the finance and investment banking industry in Europe. Throughout his career, Maude served as a top-ranked equity analyst at Kleinwort Benson Securities, Smith Barney and Dillon Read. While at Dillon Read, a prestigious U.S. investment bank, Maude served as partner and managing director of the company’s UK office. This prominent position led Maude to AXA Investment Managers where he led equity research. In 1999, Maude’s three-yearold daughter, Isabel fell seriously ill as a result of a misdiagnosis. Isabel’s illness and experience inspired Maude to abandon his city career and create Isabel Healthcare. He is also on the editorial board of the journal Diagnosis.


 

Tobias Mueller has an educational background in computer science and medicine. Since 2014, he is working at the center for undiagnosed and rare diseases at the university clinic, Marburg, Germany. Established in December 2013, the center assists patients and physicians with diagnostic proposals in complex cases. The inquiries are generally patient initiated and the center is open to the general public. Dr. Mueller’s research activities focus on the evaluation of computerized decision support tools in rare and undiagnosed diseases and epidemiological aspects of these patient group. Since 2017, he also serves as head of digital tranformation for Rhön-Klinikum AG, a private healthcare provider with hospitals in five locations and about 16,500 employees across Germany.


 

Christiana Naaktgeboren, MPH, PhD is an epidemiologist working at the Julius Center for Health Sciences and Primary care at the University Medical Center Utrecht. In 2015 she completed her PhD thesis on ‘Improving the methodological framework for diagnostic studies’. As an assistant professor, she continues her research on this theme and on the closely related problems of overdiagnosis and diagnostic error. In addition to methodological research, she also provides advise for studies on improving laboratory testing the department of Laboratory, Clinical Chemistry and Hematology as well as for several trials (many of which are diagnostic) within the Dutch Consortium for Healthcare Evaluation in Obstetrics and Gynecology. She has co-authored over 20 publications in the field of diagnosis or prognosis.


 

Mathieu Nendaz is an internist at the Geneva University Hospitals and trained in health professions education at the University of Illinois at Chicago. He is presently also Director of the Unit of Development and Research (UDREM) and Professor at the Faculty of Medicine, University of Geneva, Switzerland. His research interests include Internal Medicine and Medical Education. In this field, he is particularly interested in decision-making, clinical reasoning, clinical supervision, and interprofessional issues. He is deeply involved in direct teaching, clinical supervision and training, as well as in the development and organization of teaching concepts and medical curriculum.




David Newman-Toker, MD PhD, is an internationally-recognized leader in neuro-otology, acute stroke diagnosis, and the study of diagnostic errors. He completed his training at Yale University, University of Pennsylvania School of Medicine, Harvard University, and Johns Hopkins Bloomberg School of Public Health. He has served as a full-time faculty member at the Johns Hopkins University School of Medicine since 2002. He is Professor of Neurology, Otolaryngology, and Ophthalmology, with joint appointments in Emergency Medicine, Acute Care Nursing, Health Sciences Informatics, Epidemiology, and Health Policy & Management. Dr Newman-Toker’s clinical and research focus is in diagnosis of acute disorders affecting the brainstem and cranial nerves, particularly stroke. He serves as Director of the Division of Neuro-Visual & Vestibular Disorders in the Department of Neurology. He also directs the Armstrong Institute Center for Diagnostic Excellence whose mission is to catalyze efforts to improve diagnostic performance, develop the science of diagnostic safety, and enhance diagnostic research. He has been the principal investigator for multiple NIH, AHRQ, and foundation grants. Mr Newman-Toker has published over 100 journal articles and given more than 200 invited lectures on dizziness and diagnostic errors. He is a leader in the national and international movements to eliminate patient harms from diagnostic error. He has served as an expert consultant on diagnostic safety and quality to AHRQ, the National Academy of Medicine, and the National Quality Forum. He currently serves as President-Elect of the Society to Improve Diagnosis in Medicine (SIDM) and as well as Chair of SIDM’s Policy Committee.


 

Art Papier, MD is a founder of VisualDx and CEO. A dermatologist, and medical informaticist, Art has a particular interest in designing clinical systems that leverage the human ability for pattern recognition, thereby increasing clinical accuracy and reducing diagnostic error at the point of care. In line with this goal, he has led the development of VisualDx, the first diagnostic clinical decision support system to be widely used. Art is also passionate about the engagement of people in their medical decisions, in consumer health, and developing tools to educate and empower patients in their homes and on their mobile devices.

A graduate of Wesleyan University, Art received his MD from the University of Vermont College of Medicine, and completed his graduate medical training at the University of Rochester Medical Center. He is also an Associate Professor of Dermatology and Medical Informatics at the University of Rochester School of Medicine and Dentistry.




Mario Plebani obtained his medical degree summa cum laude from the Medical School of the University of Padova in 1975. He completed residency training and specialization in Laboratory Medicine (1978), and subsequently in Gastroenterology (1983), at the same University. He is full Professor of Clinical Biochemistry and Clinical Molecular Biology at the School of Medicine, University of Padova and Chief of the Department of Laboratory Medicine at the University-Hospital of Padova. He is also the Dean of the Medical School of the University of Padova and Chief of the Center of Biomedical Research (a specialized Center for quality in laboratory medicine for the Veneto Region). Honorary Professor at the University of Buenos Aires (Argentina), Facultad de Farmacia y Bioquimica, he served as President of the International Society of Enzymology for four years (2004-2008), as President of the Italian Society of Clinical Biochemistry and Molecular Clinical Biology for five years (in 2003 and from 2007 to 2009) and President of the federation of Italian Societies of Laboratory Medicine (FISMeLAB) from 2009 to 2012.

Prof. Plebani is Editor-in-Chief of Clinical Chemistry and Laboratory Medicine, and Editor in Chief of Diagnosis.

He has published 1100 full papers, more than 900 abstracts and several books and book chapters, HI 88 (20.351 citations with an average per year of 371 citations), and an Impact Factor of 984.495 in the last three years. His main areas of research are quality management in laboratory medicine, diagnostic and laboratory errors, biomarkers in cancer and cardiovascular diseases, and in vitro allergy diagnostics.


 

Cécile José Ravesloot, MD, PhD, graduated from Medical School at the University of Utrecht in The Netherlands in 2005. After she worked for a short period at the emergency department of St Jansdal Hospital in Harderwijk, The Netherlands, and as a junior teacher at the department of anatomy of the University Medical Center Utrecht, she was trained as a radiologist at the University Medical Center in Utrecht and Gelre ziekenhuizen Apeldoorn till August 2017. In addition to her radiology training she was radiology teacher at UMC Utrecht and was involved in several educational projects which aimed to improve radiology educational and assessment programs. In March 2016 she defended her PhD-thesis “Assessing Expertise in Radiology”. Since October 2017 she works as a radiologist at Radboudumc in Nijmegen, The Netherlands.




Kerstin Ritter, PhD, is a mathematician, specialized on developing machine learning techniques for analyzing neuroimaging data in various disease contexts (e.g. multiple sclerosis, dementia or obsessive-compulsive disorder). Since October 2017, she is P.I. in the DFG-funded project “Deep Learning for neuroimaging-based disease decoding” at the Berlin Center for Advanced Neuroimaging and Bernstein Center for Computational Neuroscience Berlin (Charité - Universitätsmedizin Berlin). Additionally, she was recently awarded a Rahel-Hirsch scholarship.


 

David Schwappach is scientific director of the Swiss Patient Safety Foundation since 2008 and professor for Patient Safety at the Institute of Social and Preventive Medicine (ISPM) at the University of Bern. David obtained a PhD in theoretical medicine in 2001 and received the venia legendi for Public Health in 2006. His research interests reside in acute care patient safety, including patient safety in clinical cancer care, communication between health care professionals, systems and process design, and implementation of safety measures into clinical practice. David Schwappach is engaged in teaching patient safety to various audiences, including medical students, postgraduate students of public health, and clinicians from many disciplines and professions. He serves as a referee for a variety of international journals and institutions and is member of several Patient Safety Boards.




Susan E. Sheridan, MIM, MBA, DHL, currently serves as the Director of Patient Engagement for the Society to Improve Diagnosis in Medicine (SIDM) where she spearheads efforts to ensure that the patient and family perspective informs all facets of SIDM’s work to improve diagnostic accuracy and timeliness while reducing harm caused by diagnostic errors.

Prior to her work at SIDM, Ms Sheridan served as Patient and Family Engagement Adviser at the Centers of Medicare and Medicaid Services (CMS) where she helped integrate the Person and Family Engagement Strategy throughout the CMS community. Previous to her joining CMS, Ms Sheridan served as the Director of Patient Engagement for the Patient-Centered Outcomes Research Institute (PCORI), where she lead the Patient Engagement team, who developed and implemented programs and processes to encourage meaningful engagement of patients and other stakeholders in all of PCORI’s activities and the research that they funded.  Before joining PCORI, she was the external lead of the Patients for Patient Safety program at the World Health Organization (WHO), where she helped develop and implement a global network of patients who built country and regional strategic plans for patient engagement for various WHO initiatives. Ms Sheridan had previously spent 10 years in patient advocacy inspired by adverse family experiences in the healthcare system. She cofounded and is past president of Parents of Infants and Children with Kernicterus (brain damage from jaundice), who engaged with the healthcare system to implement a new standard of care in jaundice management. She is also cofounder of Consumers Advancing Patient Safety, which helps organizations engage patients as partners in developing patient-safety solutions. Prior to her leadership in patient engagement, she worked as a finance banker for international trade. Sue received her BA from Albion College, her MIM and MBA from the Thunderbird School of Global Management and her DHL from Adrian College.




Hardeep Singh, M.D., M.P.H., is Chief of Health Policy, Quality & Informatics Program at the VA Center for Innovations in Quality, Effectiveness and Safety and a Professor of Medicine at Baylor College of Medicine in Houston. He leads a portfolio of patient safety research in improving the use of health information technology and reducing diagnostic errors. His research has informed several national and international patient safety initiatives and policy reports, including those by the National Academy of Medicine (formerly the IOM), US Department of Health and Human Services, National Quality Forum, American Medical Association, Agency for Healthcare Research and Quality, OECD and the WHO. Dr Singh has received several prestigious awards for pioneering work in the field, including the AcademyHealth Alice S. Hersh New Investigator Award in 2012, the Presidential Early Career Award for Scientists and Engineers (PECASE) from President Obama in 2014 and the VA Health System Impact Award in 2016.




Maarten ten Berg, PharmD, PhD, is a clinical chemist at the Department of Clinical Chemistry and Hematology of the University Medical Center Utrecht. In the clinical laboratory, he is professionally responsible for pre-analysis and clinical trial services. Mr ten Berg’s ambition is to establish a patient-oriented laboratory service that contributes to safe and effective patient care. As a trained epidemiologist he works toward this goal by conducting clinical and observational research using large clinical databases, currently focused on test utilization management.




Laura Zwaan, PhD, is an assistant professor at the Institute of Medical Education Research Rotterdam (iMERR) of the Erasmus MC in Rotterdam. Ms Zwaan has a background in cognitive psychology and epidemiology and obtained a PhD degree on Diagnostic reasoning and Diagnostic error in medicine from the VU University Medical Center in Amsterdam, the Netherlands. She received prestigious VENI and Erasmus MC fellowship grants for her research on diagnostic reasoning. She has (co-)authored more than 25 publications in the field of patient safety. In addition to her work as a researcher, she was the chair of the Diagnostic Error in Medicine 1st European conference in 2016 and the chair of the research committee of the Society to Improve Diagnosis in medicine (SIDM) from 2015-2017. Ms Zwaan is on the editorial board of the journal Diagnosis.




Wolf Hautz, MD, MME is assistant professor of medical education and senior attending physician in emergency care at Inselspital University Hospital Berne, Switzerland. His training is in anesthesiology, emergency medicine, ultrasound and educational research. His research focuses on diagnostic decision making under ill-defined conditions and on collaborative decisions in particular. He has published more than 30 peer reviewed papers and is chair of the 2nd European Conference on Diagnostic Error to be held in Berne in August.

 

Location

The conference will take place at:

Kinderklinik (Childrens Hospital)

Ettore Rossi (lecture hall Ettore Rossi)

Inselspital University Hospital Bern, Switzerland

 

Getting There

By plane: Bern has a small airport with connections to only a few European cities. Larger airports are located in Basel and Zurich, both with decent train connections to Bern (one-hour train ride). Geneva has another international airport, around 2 hours by train.
 
By train: Bern Hauptbahnhof (Bern central station) is a 15-minute walk or a 5-minute bus ride from Inselspital. Take bus number 11 heading to “Holligen” and get off at “Inselspital”, not “Inselplatz”.
 
By car: Exit A1 at “Forsthaus / Inselspital” and follow the signs to “Inselspital”, about 5 minutes by car from the highway. Parking at and around Inselspital is very limited and expensive. We advise you not to come by car.

 

From AMEE 2018 Basel: AMEE will generously offer a free transfer to participants of both conferences.

Registration

Fees (Swiss Francs)

 

Early Bird*

Regular

On-site

 

1 day

2 days

1 day

2 days

1 day

2 days

Full Fee

210.00

380.00

240.00

440.00

270.00

490.00

Reduced Fee

130.00

220.00

160.00

280.00

190.00

330.00

* Early bird registration ends June 10, 2018.

Fees listed are in Swiss Francs (CHF).  Conversion

 

Register

 

Reduced fees for full time students, PhD students, non-physician health professionals such as nurses, lab technicians, physician assistants, physiotherapists; (proof required at on-site registration)

 

Participants of AMEE 2018 receive a 10% discount. Discount will be payed on-site upon request (AMEE badge required).

 

Registration fee includes: conference participation and lunch and coffee breaks but not accommodations, travel, transport, or dinner. Participation in the "Meet the faculty" dinner is at your own expense.

 

Dinner on August 30, 2018: Restaurant close to conference premises and for EuroDEM participants only. Costs CHF 60 (payable with the registration fee) including salad/grill/dessert buffet and beverages.

 

Cancellation fee
Cancellation until August 1, 2018: CHF 30
Cancellation after August 1, 2018: No refund

 

Please note: Book your accommodation in Bern early.

Please check hotel availability as soon as possible. We recommend that you book your hotel at www.booking.com. You may also contact the tourist office www.bern.com if you need assistance.

Accreditation

The “2nd European Conference on Diagnostic Error in Medicine, Bern, Switzerland, 30/08/2018-31/08/2018” has been accredited by the European Accreditation Council for Continuing Medical Education (EACCME®) with 10 European CME credits (ECMEC®s). Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity.

Through an agreement between the Union Européenne des Médecins Spécialistes and the American Medical Association, physicians may convert EACCME® credits to an equivalent number of AMA PRA Category 1 CreditsTM. Information on the process to convert EACCME® credit to AMA credit can be found at www.ama-assn.org/education/earn-credit-participation-international-activities.

Live educational activities, occurring outside of Canada, recognised by the UEMS-EACCME® for ECMEC®s are deemed to be Accredited Group Learning Activities (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.

30 August: 6 credits
31 August: 4 credits

Society to Improve
Diagnosis in Medicine
1501 Hinman Ave, #7B
Evanston, Il 60201

info@improvediagnosis.org