TUESDAY, July 20 (HealthDay News) -- Physicians often ignore contextual red flags presented during patient encounters, which may ultimately lead to medical errors, according to research published in the July 20 issue of the Annals of Internal Medicine.

Saul J. Weiner, M.D., of the University of Illinois at Chicago, and colleagues conducted a multicenter study of the conditions under which physicians probe "red flags" -- of either a contextual or biomedical nature -- presented during patient encounters. The researchers used standardized patients presenting with four different clinical scenarios to a total of 111 internal medicine physicians. Measured outcomes included the proportion of visits in which physicians searched for contextual and biomedical factors in response to red flags or hints given by the standardized patient and the proportion of visits that resulted in treatment plans that were error-free.

The researchers found that physicians were less likely to probe further for contextual red flags (51 percent) than for biomedical red flags (63 percent). Error-free care was provided in 73 percent of the uncomplicated encounters, 38 percent of the biomedically complicated encounters, 22 percent of the contextually complicated encounters, and 9 percent of the combined biomedically and contextually complicated patient encounters.

"Although tracking physician adherence to guidelines as a quality indicator is straightforward, determining whether physicians are appropriately individualizing care is not. Broadening the assessment of physician performance to include this metric unmasks serious performance problems," the authors write.

Abstract
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