Horizontal and vertical tracing: a cognitive forcing strategy to improve diagnostic accuracy

Postgrad Med J. 2020 Oct;96(1140):581-583. doi: 10.1136/postgradmedj-2020-137548. Epub 2020 Aug 12.

Abstract

Reducing diagnostic error is a major issue in medical care. Various strategies have been proposed to prevent diagnostic error. The most prevalent factor for the diagnostic error is a cognitive error by physicians; reducing the cognitive error should lead to a substantial reduction in diagnostic error. That said, few studies have described new strategies to increase diagnostic accuracy that focuses on the cognitive processes of physicians. The current study describes new diagnostic strategies using cognitive forcing. Horizontal tracing is a strategy to identify comorbidities reliably, and vertical tracing identifies an underlying condition.

Keywords: Internal medicine.

MeSH terms

  • Cognition
  • Comorbidity
  • Diagnostic Errors / prevention & control*
  • Humans
  • Physicians*
  • Thinking*