Uso de heurísticos y error diagnóstico en Atención Primaria: revisión panorámica

Minué-Lorenzo, Sergio; Fernández-Aguilar, Carmen; Martín-Martín, José Jesús; Fernández-Ajuria, Alberto

doi:10.1016/j.aprim.2018.11.003

Cited by 4 publications

(3 citation statements)

References 67 publications

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“…Moreover, there is solid evidence that not only has the overall prevalence rate of ADHD medication prescriptions increased during the last decade (e.g. [5,19,30,40]), it is a rate also significantly higher for boys than girls [18,20,40]. In this regard and as our study confirmed, the occurrence of ADHD overdiagnoses is significantly linked to psychostimulant prescriptions, especially for boys.…”

Section: Discussion/conclusionsupporting

confidence: 79%

“…Unfortunately for this hypothesis, Iranian parents also rated girls as high as boys on statisticallyderived and DSM-oriented scales of ADHD problems, unlike parents in the other populations. The similar findings for Iranian parent and teacher ratings indicate crossinformant and cross-situational consistency in Iranian adults' tendency to rate Iranian girls as high as boys on ADHD problems" [30]. Furthermore, a recent metaanalysis of 27 studies (N = 15,124) for the years of 2001 to 2016 reported a prevalence rate of ADHD of 12% (CI 95%: 9.0-15) for children aged six to 14 years in Iran [37].…”

Section: Adhd In Iranmentioning

confidence: 58%

“…On the other hand, although these factors can function as short circuits of decision making in clinical situations, they may introduce bias result in error. In this regard, undervaluing the later information, omission of less distinguished but still considerable data, and too much focus on pattern recognition are sources of possible risks in adopting heuristics [29,30]. Furthermore, Metta [31] showed that heuristic bias may depend on years of job experience.…”

Section: Adhd Overdiagnosis and Issue Of Gender Biasmentioning

confidence: 99%

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ADHD overdiagnosis and the role of patient gender among Iranian psychiatrists

et al. 2021

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Background Regarding the controversy about the overdiagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) in children and adolescents there are two main directions addressed as issue of age bias and issue of gender bias. In this relation, replication of findings demonstrating significant overdiagnosis is of importance which make the systematic evaluation of such occurrence necessary. Objective The seminal study by Bruchmüller, Margraf & Schneider, 2012 is replicated here, although in a different cultural context, in this case Iran, as ADHS might be perceived differently there. We assessed both gender bias and the impact of potential overdiagnosis on treatment recommendations. Methods A total of 344 licensed Iranian psychiatrists (mean age = 45.17, SD = 9.50) participated in this study. Each psychiatrist received a cover letter that introduced the study as well as a case vignette. Overall, there are eight different cases, one child with ADHD and three non-ADHD children, for both a boy (Ali) and a girl (Sara). Participants also received a questionnaire requesting their particular diagnosis, treatment recommendation and the therapist’s sociodemographic information. Chi square tests and multiple logistic regression were applied for data analyses. Results Overdiagnosis occurred in both girl and boy children, although overdiagnosis was 2.45 more likely in boys than in girls (p < 0.01). With respect to the psychiatrist’s gender, we detected no difference between males or females, as both overdiagnosed ADHD in boys (pfemale < 0.01 and pmale < 0.01). Furthermore, ADHD overdiagnosis had a direct impact on medication prescription (p < 0.01). Conclusion This study suggests that diagnosticians should strictly adhere to diagnostic criteria to minimize diagnostic error.

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