Case Presentation: A 56-year-old male with a history of 45 pack-year smoking, peptic ulcer, and cholecystectomy 5 months ago presented with worsening epigastric pain and 70-pound weight loss over the last 3 months, associated with subjective fevers, drenching night sweat, and malaise. The patient was hospitalized a month ago for the same reason, when computed [...]

Background: It is important to understand knowledge about diagnostic error, such as cognitive bias and heuristics, for preventing a diagnostic error. However, it is unclear whether Japanese residents learn this knowledge. We aimed to assess diagnostic error knowledge in residents throughout Japan and compare it to the benchmark of the previous US score. In addition, [...]

Background: Anemia is a risk factor for cognitive impairment as a result of the reduced delivery of oxygen to the brain from low hemoglobin (Hb) levels. In ambulatory patients even mild anemia (Hb < 12g/dL) has been associated with reductions in patients’ cognitive function. However, in hospitalized patients it is standard of care to maintain [...]

Background: In medical care for older patients, the presence of potentially inappropriate medications (PIMs) is associated with increased adverse outcomes [1, 2]. A wide range of medications with anticholinergic properties affects cognitive states of older patients have been regarded as PIMs [1, 3]. We purposed to assess clinical impact of anticholinergic cognitive burden on clinical [...]

Background: Medical school is crucial in giving students both the knowledge and the professional identity required to be a doctor. While there are numerous formal options at our medical school for senior medical students to assist in the former, there are far fewer for the latter. Our group is investigating the possibilities of senior medical [...]

Background: The number of individuals with dementia in the U.S., currently estimated at 5.3 million, is projected to triple by 2050. For patients with cognitive impairment, the unfamiliar and stressful hospital environment often requires constant observation (CO) to ensure patient safety. The use of constant observation (CO) in the hospital setting, while originating in patients [...]

Background: Decision fatigue describes the erosion of decision making capacity as a consequence of the repeated acts of decision making. The phenomenon has been detected in ambulatory settings with higher rates of inappropriate antimicrobial and opiate prescribing and lower rates of cancer screening associated with appointments that occur later in the day. As hospital medicine [...]

Background: Alzheimer disease (AD) is characterized by cognitive impairment including memory impairment, executive dysfunction, visuospatial impairment, and behavioral changes. Previous studies have shown that increasing level of physical activity serves as a protective factor against progression of AD. This study aims to assess the effect of long-term physical activity on cognitive function and identify whether [...]

Background: Anemia is a risk factor for cognitive impairment as a result of reduced delivery of oxygen to the brain from low hemoglobin (Hb) levels. In ambulatory patients, mild anemia (Hb 10-12g/dL) has been associated with reductions in patients’ cognitive function [1–3]. In hospitalized patients it is standard of care to maintain Hb levels far [...]

Background: Diagnostic error in medicine is increasingly recognized as “the next frontier for patient safety”. Current research has explored the etiologies of diagnostic errors in two unique dimensions: as systems-based or cognitive-based causes. One study, however, suggests that roughly half of all errors stem from both domains. Using a focused ethnographic approach, we sought to [...]