Misdiagnosis

Static ignition statistics must be used with prudence not only because of possible misdiagnosis of the cause of ignition but also because of the way the losses are often grouped together. As discussed in Chapters 5 and 6 the likeli-... 

With regard to mistakes, two separate mechanisms operate. In the rule-based mode, an error of intention can arise if an incorrect diagnostic rule is used. For example, a worker who has considerable experience in operating a batch reactor may have learned diagnostic rules that are inappropriate for continuous process operations. If he or she attempts to apply these rules to evaluate the cause of a continuous process disturbance, a misdiagnosis could result, which could then lead to an inappropriate action. In other situations, there is a tendency to overuse diagnostic rules that have been successful in the past. 

One example of a particularly hazardous type of consequence in the second category is where, because of misdiagnosis, the operator performs some alternative task other than that required by the system. For example, a rise of pressure in a reactor may be interpreted as being the result of a blockage in an output line, which would lead to attempts to clear the line. If, instead, it... 

Evidence that a misdiagnosis was involved (distinction between slips and mistakes)... 

Equilibrium phosphate concentration theory refutes the concept of blanket control determined by boiler pressure and operates each boiler system on a case-by-case basis. It seeks to strenuously avoid hideout-related problems and the subsequent risks of misdiagnosis. Operators are encouraged to explore the maximum operating tolerances before phosphate destabilization takes effect and hideout results, and to ensure... 

Bell, C. Mehta, H. (1980). The misdiagnosis of black patients with manic depressive illness. /. Natl. Med. Assoc., 72(2), 141-5. 

Figure 6.14 Schematic representation of the scoring system the example illustrated uses the Reference Center set of HER2/Chl7 ratios obtained for the SK-BR3 cell line at Run 4. In this case the lowest ratio obtained by a Reference Center was 3.19, and the highest was 4.10 participants submitting ratios within this range were judged to have achieved an appropriate result (score = 3). The lower cutoff for acceptable ratios (score = 2) was calculated as 3.19 minus 10% of 3.19, that is 2.87 and the upper cutoff was calculated as 4.10 plus 10% of 4.10, that is 4.51. Participants who submitted ratios outside these 10% cutoffs were judged to have achieved an inappropriate result and received a score of 1. Except in the case of the MDA-MB-453 cell line, misdiagnosis (amplified reported as nonamplified, and vice versa) resulted in a score of 0. Superscript notation and abbreviation used in figure Does not apply to results obtained for MDA-MB-453 cell line RC, Reference Center. See color insert.

Shortness of breath, cough, and wheeze are common symptoms of respiratory diseases (Table 3.2). These shared symptoms make misdiagnosis by physicians common if the diagnosis is based solely on reported symptoms. Medical tests help to distinguish the respiratory diseases from each other (Table 3.3). Other pitfalls in medical diagnosis include diagnosing common diseases (such as asthma, emphysema, and chronic bronchitis) instead of the actual rarer diseases (such as BO) and not considering occupational exposures as the cause. 

Symptoms of poisoning may affect all or only few individuals in a particular population. Symptoms may be divided into early, late, and delayed early symptoms occur a few hours after toxin ingestion, late symptoms up to several days after, and delayed symptoms affect patients after some weeks, or even months. The most dangerous situation involves delayed, subacute symptoms that do not affect all individuals in an analyzed population. In such a cases, a relationship between consumed food and disease symptoms is practically impossible to confirm and may lead to a misdiagnosis. 

Inadequate response A blunted or impeded therapeutic response may be due to infection, uremia, bone marrow suppressant drugs, concurrent iron or folic acid deficiency, or misdiagnosis. 

Joyce, P.R. (1984) Age of onset in bipolar affective disorder and misdiagnosis as schizophrenia. Psychol Med 14 145-149. 

After a review of the voluminous literature, this distinguished panel concluded that ADHD is one of the best researched disorders in medicine in fact, the overall data on its validity are far more compelling than those for many other medical conditions. They also concluded that there was little evidence of widespread overdiagnosis or misdiagnosis of ADHD or of widespread overprescription of stimulants by physicians. 

Misdiagnosis arises when undue emphasis is placed on symptoms such as ideas of reference Positive symptoms may occur and the onset is often rapid with relatively good premorbid functioning Distinctions such as mood congruency can be difficult to apply Negative symptoms may occur in depression... 

The improved recognition of ADHD and its response to treatment has led to a dramatic increase in methlyphenidate production and use in the United States. This increase has gained media attention and raised concerns about overdiagnosis or misdiagnosis, as well as the possibility of stimulant abuse (diversion of prescription methlyphenidate or other stimulants). However, the available evidence does not support these concerns (41). 

Stigma and misinformation can also extend into medical practice, where many depressed patients present with medically unexplained symptoms. Somatization is the term used for such use of physical symptoms to express emotional distress, which may be a major reason for misdiagnosis of mental illness by medical and psycho-... 

There is a vogue for many scientifically nonqualified aromatherapists to practice clinical aromatherapy, in which they prescribe the internal usage of essential oils. Internal prescribing involves oral, rectal, and vaginal intake however, the use of tampons soaked in various potentially toxic essential oils, such as the various tea tree oils, with variable biological potential could have a possible harmful effect on the delicate internal mucosal membranes. The possibility of misdiagnosis of a urogenital condition by medically unqualified aromatherapists or by the patients themselves could also result in serious consequences. 

Haber, Julian S. ADHD The Great Misdiagnosis. Dallas FAAP Taylor Trade... 

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