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Discordant diagnoses Discordant diagnoses included two categories: Diagnostically different discordant diagnosis: the primary ED diagnosis was not listed among the HD diagnoses (e.g., the ED diagnosis was listed as acute-on-chronic constipation, while the HD diagnosis was listed as acute pancreatitis). Concordant diagnoses Concordant diagnoses included the following categories: Identical diagnosis: the ED and HD diagnoses were either verbatim or medically identical. Keywords: concordant diagnoses; diagnostic discrepancy; diagnostic errors; discordant diagnoses; emergency department diagnosis; hospital diagnosis EN concordant diagnoses diagnostic discrepancy diagnostic errors discordant diagnoses emergency department diagnosis hospital diagnosis 107 114 8 02/07/22 20220201 NES 220201 Introduction "No two cases of the same disease are ever alike; the constitution of the person, his individuality, stamps each case with certain peculiarities." Hierarchically different discordant diagnoses: the primary ED diagnosis was listed among the HD diagnoses but was not the primary discharge diagnosis (e.g., the ED diagnoses were recurrent falls and gastroenteritis, while the HD diagnoses were femoral neck fracture, recurrent falls, and gastroenteritis). [Extracted from the article]

Abstract Background Whether early detection and treatment of prostate cancer (PCa) will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs) developed and tested, very few have included an exercise to help men clarify their values and preferences about PCa screening. Further, only one DA has utilized an interactive web-based format, which allows for an expansion and customization of the material. We describe the development of two DAs, a booklet and an interactive website, each with a values clarification component and designed for use in diverse settings. Methods We conducted two feasibility studies to assess men's (45-70 years) Internet access and their willingness to use a web- vs. a print-based tool. The booklet was adapted from two previous versions evaluated in randomized controlled trials (RCTs) and the website was created to closely match the content of the revised booklet. Usability testing was conducted to obtain feedback regarding draft versions of the materials. The tools were also reviewed by a plain language expert and the interdisciplinary research team. Feedback on the content and presentation led to iterative modifications of the tools. Results The feasibility studies confirmed that the Internet was a viable medium, as the majority of men used a computer, had access to the Internet, and Internet use increased over time. Feedback from the usability testing on the length, presentation, and content of the materials was incorporated into the final versions of the booklet and website. Both the feasibility studies and the usability testing highlighted the need to address men's informed decision making regarding screening. Conclusions Informed decision making for PCa screening is crucial at present and may be important for some time, particularly if a definitive recommendation either for or against screening does not emerge from ongoing prostate cancer screening trials. We have detailed our efforts at developing print- and web-based DAs to assist men in determining how to best meet their PCa screening preferences. Following completion of our ongoing RCT designed to test these materials, our goal will be to develop a dissemination project for the more effective tool. Trial Registration NCT00623090