on April 29, 2014
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• A vast number of patients are being misdiagnosed in outpatient clinics and doctors’ offices
• Medical malpractice is estimated to cause 40,000 to 80,000 deaths annually
• Common symptoms are often missed in cases like decompensated heart failure, pneumonia, anemia, spinal cord compression, and kidney failure
WASHINGTON – Annually about 12 million people or about 5 percent of the adults who seek care in outpatient clinics are misdiagnosed and half of those cases have potential to cause serious harm, states a new study, published in BMJ Quality and Safety.
According to the Society to Improve Diagnosis in Medicine, diagnostic error is the leading cause of medical malpractice claims in the U.S., and is estimated to cause 40,000 to 80,000 deaths annually.
Previous studies examining the rates of medical misdiagnosis have focused primarily on patients in hospital settings. But this paper suggests a vast number of patients are being misdiagnosed in outpatient clinics and doctors’ offices
“It’s important to outline the fact that this is a problem,” said Dr. Hardeep Singh, the study’s lead author and a patient safety researcher at Baylor College of Medicine in Houston and at the Michael E. DeBakey VA Medical Center, also in Houston.
“Because of the large number of outpatient visits, this is a huge vulnerability. This is a huge number and we need to do something about it,” he said in an interview with Reuters.
The data sources in the new study included two previous studies, to detect unusual patterns of return visits after an initial primary care visit, or lack of follow-up after abnormal clinical findings related to colorectal cancerboth suggestive of diagnostic errors. A third study examined consecutive cases of lung cancer.
In all three studies, diagnostic errors were confirmed through chart review and defined as missed opportunities to make a timely or correct diagnosis based on available evidence.
The researchers, based on 3,000 medical records, found that almost half of the misdiagnoses would be harmful to the patient.
common symptoms are often missed in common diseases, such as decompensated heart failure in patients, pneumonia, anemia, spinal cord compression, and kidney failure
According to lead study author Dr. Hardeep Singh, patient safety researcher at the Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, at the Michael E. DeBakey VA Medical Center in Houston, “When a patient comes in with a lot of undifferentiated symptoms, in primary care the diagnosis evolves over time and you might start with a certain work-up, but that changes.” said Singh.
Singh, who is also an associate professor at Baylor College of Medicine, urged that physicians should make patients more aware of how things will evolve and what patients need to do. In addition to cancer, Singh said that common symptoms are often missed in common diseases, such as decompensated heart failure in patients, pneumonia, anemia, spinal cord compression, and kidney failure.
“This has to be a multi-faceted effort involving physicians, their care teams, patients, and the healthcare system where we practice. Everybody plays a role.,” said Singh.
The 2012 study offered a snapshot of the symptoms doctors most frequently miss or misdiagnose. The top complaints that turned out to be symptoms of more serious conditions were cough, abdominal pain and shortness of breath.
Singh clarified that while 50 percent of the misdiagnoses may lead to complications yet not all misdiagnoses are going to lead to problems.
“You do get problems when there’s a delay in needed treatment and when you get unnecessary tests, but it’s obviously not good to get misdiagnosed for any reason,” he stated.