When people go to a doctor or see a health professional about their ailing health or problematic symptoms, chances are they think they’re going to be properly diagnosed with a health issue so they can put effective treatment plans into place.
Now, an alarming new study claims hundreds of thousands of people are dying and becoming permanently disabled each year because their medical diagnoses are initially missing conditions, are wrong or delayed.
Researchers from the John Hopkins Armstrong Institute identified three major disease categories that account for nearly three-fourths of all serious harms from diagnostic errors. The study, published in the Diagnosis Journal, found vascular events, infections and cancers are the major misdiagnosed diseases.
Diagnostics errors were found to be the most common, most catastrophic and most costly medical mistakes. These errors lead to death or serious, permanent disability in 37.8 per cent of misdiagnosed cancers, 22.8 per cent of vascular events and 13.5 per cent of infections. These ‘big three’ categories, which include 15 specific conditions, account for nearly half of all serious and misdiagnosed-related harms.
Stroke, sepsis and lung cancer were the top conditions in each category, while heart attack, venous thromboembolism, aortic aneurysm, arterial thromboembolism, meningitis, spinal infection, pneumonia, endocarditis and breast, colorectal, prostate and skin cancers also causing concern.
“We know that diagnostic errors happen across all areas of medicine. There are over 10 thousand diseases, each of which can manifest with a variety of symptoms, so it can be daunting to think about how to even begin tackling diagnostic problems,” lead researcher David Newman-Toker said in a statement.
“Our findings suggest that the most serious harms can be attributed to a surprisingly small number of conditions. It still won’t be an easy or quick fix, but that gives us both a place to start and real hope that the problem is fixable.”
Researchers analysed 11,592 diagnostic error cases between 2006 and 2015 from the US national Comparative Benchmarking System (CBS) database. They discovered different diagnosis ‘codes’ that represent strokes, heart attacks and other conditions that are used in treatment, but grouping the codes together to identify common harms from diagnostic error hadn’t been done before.
“Doing so gives us an ‘apples to apples’ comparison of the frequency of different diseases causing harms,” Newman-Toker said.
Based on the data, it was determined that failures of clinical judgement were identified as causes in more than 85 per cent of misdiagnosed cases. Researchers believe health care systems need to do more to support bedside diagnostic decision-making and interventions such as computer-based diagnostic decision support tools and increasing immediate access to specialists at the point of care could make a big difference.
The study also found that 71.2 per cent of diagnostic errors occurred in emergency departments (where infections of vascular events were missed) or outpatient clinics (where misdiagnoses were more likely to be cancer-related).
“These findings give us a road map for thinking about what kind of problems we need to solve in which clinical settings,” Newman-Toker said.
While the study focuses on serious health issues, other chronic problems including migraines and multiple sclerosis weren’t included by can be misdiagnosed for years or decades before appropriate treatment is offered. The next phase of the study will estimate how frequently the 15 common issues are misdiagnosed.
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