1 in 10 Infections, Cancers, Vascular Events Are Misdiagnosed
Nearly 1 in 10 patients with symptoms of major vascular events, infections, or cancers will be misdiagnosed, according to the results of a recent study.
“Missed vascular events, infections, and cancers account for ~75% of serious harms from diagnostic errors. Just 15 diseases from these “Big Three” categories account for nearly half of all serious misdiagnosis-related harms in malpractice claims,” the researchers wrote.
As part of a larger analysis estimating misdiagnosis-related harms in the US, the researchers conducted a literature review focusing on the 5 most frequent diseases in each of the “Big Three” categories, including stroke, myocardial infarction, venous thromboembolism, aortic aneurysm and dissection, and arterial thromboembolism; sepsis, meningitis and encephalitis, spinal abscess, pneumonia, and endocarditis; and lung cancer, breast cancer, colorectal cancer, prostate cancer, and melanoma.
Overall, they included 28 published studies involving 91,755 total patients. They found that diagnostic error rates ranged from 2.2% (myocardial infarction) to 62.1% (spinal abscess), with an aggregate mean of 9.7% (projection pursuit regression 8.2-12.3). Rates of serious misdiagnosis-related harms per incident disease case ranged from 1.2% (myocardial infarction) to 35.6% (spinal abscess, with an aggregate mean of 5.2% (projection pursuit regression 4.5-6.7).
“We estimate that roughly one in 10 patients with a dangerous “Big Three” disease is misdiagnosed, and roughly half of those misdiagnosed die or are permanently disabled as a result,” they concluded. “These findings will immediately facilitate creation of national estimates of aggregate harms from diagnostic error. Simultaneously, they should also help guide and focus future diagnostic improvement initiatives toward conditions where current diagnostic performance is lacking.”
—Michael Potts
Reference:
Newman-Toker DE, Wang Z, Zhu Y, et al. Rate of diagnostic errors and serious misdiagnosis-related harms for major vascular events, infections, and cancers: toward a national incidence estimate using the “Big Three.” Published online May 14, 2020. De Gruyter. doi:10.1515/dx-2019-0104