Almost 800,000 Americans are permanently disabled or die each year due to a medical misdiagnosis, according to a new study in which researchers warn that the alarming rate of diagnostic errors constitute a public health crisis.
This latest study is similar to prior research identifying medical misdiagnosis as a major public health concern, which impacts more than 6 million patients every year.
These deadly diagnostic errors can result in missed or postponed detection of serious ailments and diseases, which can lead to treatment delays affecting quality of life and survival chances.
Top 5 Misdiagnosed Health Conditions
In this latest study, John Hopkins University researchers analyzed data from prior trials to identify the health conditions most often linked with diagnostic errors in the U.S. Their data included reports from various healthcare settings, including hospitals, urgent care centers, and physician offices.
Of those the conditions linked to the highest rates of harm from diagnostic errors, researchers identified five specific injuries that account for 38.7% of the problems, including: stroke, sepsis, pneumonia, venous thromboembolism (a blood clot in a vein), and lung cancer.
Stroke was the top cause of diagnostic errors that resulted in death or permanent disability, with a failure to diagnose found in 17.5% of cases.
“These are relatively common diseases that are missed relatively commonly and are associated with significant amounts of harm,” said Dr. David Newman-Toker, a neurologist at Johns Hopkins University who led the study’s research team.
Although those five conditions aren’t the most frequently misdiagnosed, they have the largest impact, and the study findings can help prioritize areas for investment and interventions, he said.
Spinal abscess, an infection of the central nervous system, is misdiagnosed more than 60% of the time, according to the report. But with 14,000 new cases each year overall, that leads to about 5,000 serious harms – a relatively small portion of the overall burden of diagnostic error.
But stroke, which the report found to be the top cause of serious harm, is a relatively common condition with a high risk of severe outcomes, and it’s misdiagnosed more often than average. About 950,000 people have a stroke each year in the U.S., and it’s missed in about 18% of cases, according to the report – leading to about 94,000 serious harms each year.
How Diagnostic Errors Occur
“Patients should not panic or lose faith in the healthcare system,” the researchers wrote in the study. Overall, there’s less than a 0.1% chance of serious harms related to misdiagnosis after a healthcare visit.
Diagnostic errors are typically the result of attributing non-specific symptoms to something more common and perhaps less serious than the condition that is actually causing it, experts say.
When someone has trouble speaking and moving an arm, it’s easy to diagnose a stroke. But a stroke can also cause dizziness or headache, which can be symptoms of many other things.
Heart attacks can also cause vague symptoms such as general chest pain. But they are significantly less likely to be misdiagnosed, with less than a 2% error rate, according to the report.
Reducing Diagnostic Errors
The success in diagnosing heart attacks required decade of concentrated efforts, Newman-Toker said. The process started by recognizing that misdiagnosis was a problem, which led to investment of funds into research and regulatory requirements around monitoring performance.
“You end up ultimately with a system of care that focuses on not missing heart attacks,” he said. “It’s the model for what we could be doing.”
The researchers recommended more funding to further explore the root causes of medical misdiagnosis. They noted that diagnostic errors are currently one of the most underfunded healthcare research issues, and urged the healthcare community to increase diagnostic error research budgets.
Connecting the Dots
“Diagnostic errors are errors of omission,” contributed Dr. Daniel Yang, an internist and program director for the diagnostic excellence initiative at the Gordon and Betty Moore Foundation. “The diagnostic journey is really not a single decision at one point of time. It’s an odyssey that unravels overnight, in some cases, days, weeks, months, even years. It cuts across multiple care settings and different types of doctors.”
But various points of care are disconnected, and providers often don’t have a full understanding of a patient’s history, he said.
That fragmentation – with scattered records from each encounter with primary care, specialists, clinics and emergency rooms – presents opportunities for info to be lost along the way, leaving the patient to put all the puzzle pieces together on their own.
The researchers stressed that doctors can avoid diagnostic errors by utilizing available health information technology, such as making sure that electronic patient charts are accessible throughout a healthcare system.
In addition, they pointed to several new technologies that are already implemented within the Johns Hopkins healthcare system to reduce misdiagnosis risks, such as electronic algorithms that are intended to identify situations that may result in a missed stroke diagnosis.
The Patient’s Role
A 2015 report from the National Academies of Sciences, Engineering, and Medicine highlighted ways that patients could play a role in their own diagnostic journey, with a checklist that includes
– keeping a good record of personal medical history,
– staying informed about relevant conditions, tests and medications, and
– following up with providers with questions about any changes or next steps.
– Patients must also seek help and get it earlier.
“The hospital can provide perfect diagnostic care. But if someone spends months waiting to see a doctor in the first place, it doesn’t matter how good the healthcare system is, because the stage of diagnosis is going to be later,” he said.
- Amount of Medical Diagnosis Errors Should Concern You
- Researches call misdiagnosis a public health crisis
- Diagnostic Errors are linked to nearly 800,000 deaths or cases of permanent disability in US each year, study estimates
- A new report found stroke to be the top cause of serious harms related to diagnosis errors in the United States, leading to about 94,000 deaths or permanent disabilities each year.
- Nearly 40% of severe outcomes from misdiagnosis are from five commonly occurring conditions.