We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Origins of Diagnostic Error—Reply

Hardeep Singh, MD, MPH1,2; Eric J. Thomas, MD, MPH3
[+] Author Affiliations
1Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
2Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
3Division of General Medicine, Department of Medicine, University of Texas at Houston–Memorial Hermann Center for Healthcare Quality and Safety, University of Texas Medical School at Houston, Houston
JAMA Intern Med. 2013;173(20):1926-1927. doi:10.1001/jamainternmed.2013.9717.
Text Size: A A A
Published online


In Reply We welcome the opportunity to respond to Drs Norris and Iwasaki to clarify the premise of our study. Although our study did not directly comment on Lawrence Weed’s work, we recognize and admire his contributions. However, the reality is that it has been challenging to translate some of Dr Weed’s concepts to the frontlines of busy primary care settings with information systems that are not yet mature enough to provide adequate cognitive support to physicians.1 We believe it is neither futile nor too late to study diagnostic errors in real-world practice settings because empirical data are essential to validate and refine our conceptual understanding of the problem.2 For instance, although we acknowledge the limitations of any given individual’s medical knowledge, in fact it appears unlikely that knowledge deficits contributed substantially to the errors we observed, since most of the conditions missed were common diseases.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





November 11, 2013
David C. Norris, MD; Justin M. Iwasaki, MD, MPH
1David Norris Consulting, LLC, Seattle, Washington
2Department of Family Medicine, University of Washington, Seattle
JAMA Intern Med. 2013;173(20):1925-1926. doi:10.1001/jamainternmed.2013.9718.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...