Evidence on Use of Clinical Reasoning Checklists for Diagnostic Error Reduction

Content-Specific Checklists

Study	Description of the Checklist	Participants	Setting	Outcome
Sibbald, et al., 2013⁷	ECG interpretation checklist	Cardiology fellows	Experimental	Checklist was effective. Average of 0.39 errors in checklist condition versus 1.04 in non-checklist condition.
Sibbald, et al., 2013⁹	Cardiac exam checklist	Internal medicine residents	Experimental	Checklist was effective. Accuracy improved from 46% pre-checklist condition to 51% post-checklist condition. The checklist was only effective if the residents could access more information while using the checklist.
Ely and Graber, 2015¹¹	Differential diagnosis checklist	Primary care physicians	Clinical	No significant difference between checklist condition and control condition.
Kok, et al., 2017¹⁰	Chest radiograph interpretation checklist	Medical students	Experimental	More abnormalities were correctly detected when the checklist was used (41.9% accuracy without checklist and 50.1% with checklist).

O’Sullivan and Schofield,
2019¹³

Mnemonic tool (SLOW) focused on slowing down reasoning and countering specific biases

Medical professionals (ranging from medical students to attending physicians)

Experimental

No significant difference between checklist condition and control condition.

Study	Description of the Checklist	Participants	Setting	Outcome
Shimizu, et al., 2013¹⁶	Differential diagnosis checklist (content specific) compared with a general debiasing checklist (process focused) and a control group (intuitive diagnosis)	Medical students	Experimental	Significant effect for the use of the content-specific checklist compared with intuitive diagnosis. The checklist particularly improved accuracy in the difficult cases. No significant effect for the debiasing checklist.
Sibbald, et al., 2019¹⁴	ECG interpretation checklist (content specific) compared with a cognitive debiasing checklist (process focused) and a control group	Internal medicine residents and cardiology fellows	Experimental	No overall significant differences between the content-specific checklist, process-focused checklist, and control group.