Misdiagnosis is linked to nearly 800,000 deaths or permanent disabilities in the U.S. each year, study estimates

CNN
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According to one report, misdiagnosed diseases and other medical conditions cause hundreds of thousands of deaths and permanent disabilities in the United States each year. report Published this week.

As a result, about 371,000 people die each year, and 424,000 people are left with permanent disabilities such as brain damage, blindness, loss of limbs and organs, and cancer metastasis.

To make an estimate, the researchers consulted dozens of previous studies to assess how often certain conditions are missed and how often those mistakes lead to significant harm. The risk was then scaled by the incidence of new infections in the total US population.

“Patients should not panic or lose faith in the healthcare system,” the researchers said in their study. Overall, he has less than a 0.1% chance of serious harm associated with a misdiagnosis after medical attention.

Nearly 40% of severe outcomes, including death and permanent disability, are associated with misdiagnosis of five disease groups: stroke, sepsis, pneumonia, venous thromboembolism (blood clots in veins), and lung cancer.

“These are relatively common diseases, but they are relatively overlooked and do a lot of harm,” said Dr. David Newman Toker, a neurologist at Johns Hopkins University. He led a research team at the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence in collaboration with researchers from the Risk Management Foundation at Harvard Medical Institutions.

These five conditions aren’t the most frequently misdiagnosed, but they have the most impact, he said, and research findings could help prioritize areas of investment and intervention.

Spinal cord abscess, a central nervous system infection, is misdiagnosed more than 60% of the time, according to the report. Overall, however, there are 14,000 new infections each year, leading to about 5,000 serious harms, a relatively small portion of the overall burden of diagnostic errors.

However, the report found stroke to be the single greatest cause of serious harm, a relatively common disease with a high risk of serious outcomes and a higher than average rate of misdiagnosis. About 950,000 people in the United States suffer a stroke each year, and about 18% of cases are missed, leading to about 94,000 serious injuries each year, according to the report.

Experts say diagnostic errors are usually attributed to nonspecific symptoms that are more common and perhaps less severe than the actual causative symptoms.

“Sometimes people are hurt by improper treatment for diseases they don’t have,” Newman-Toker said. “More common are life-threatening illnesses that are overlooked because symptoms are mild or inconspicuous.”

Diagnosing a stroke is easy when you have difficulty speaking or moving your arms. However, stroke can also cause dizziness and headaches, which can be a variety of other symptoms.

A heart attack can also cause vague symptoms, such as generalized chest pain. But the report says the chance of being misdiagnosed is much lower, with a misdiagnosis rate of less than 2%.

It took 10 years of focused effort to successfully diagnose a heart attack, Newman-Toker said. This process began with recognizing that misdiagnosis was a problem, and led to the investment of funds in research and regulatory requirements for performance monitoring.

“Ultimately, we need a treatment system focused on not missing a heart attack,” he says. “This is a model of what we can do.”

In general, however, diagnostic errors differ from other areas of patient safety, such as wrong-site surgery, falls, and medication errors. The reason is that the link between behavior and outcome is not direct, said Daniel Yang, Ph.D., an internist at the Gordon and Betty Moore Foundation and program director of the Superior Diagnostics Program.

“Diagnostic errors are omission errors,” said Yang, who was not involved in the new study. “The problem is: [the outcome] Could it have been prevented if something had been done differently earlier? More often than not, it would result in two doctors making different decisions. ”

And broader systemic problems in the healthcare system challenge that process.

“The diagnostic process isn’t really a one-time decision,” Yang said. “It’s a journey that unfolds overnight, sometimes over days, weeks, months, even years. It spans multiple medical settings and different kinds of doctors.”

But various medical settings are not aligned, and providers often don’t fully understand a patient’s medical history, he said. With records scattered about each encounter with primary care, specialists, clinics, and emergency rooms, this fragmentation creates opportunities for information to get lost along the way, leaving patients to put together all the puzzle pieces themselves.

2015 report Researchers from the National Academy of Sciences, Engineering and Medicine highlighted how patients can play a role in their own diagnostic process with a checklist that includes properly recording a personal medical history, staying up-to-date on relevant conditions, tests and medications, and asking healthcare providers about changes and next steps.

This study specifically captures the diagnostic errors of patients seen in the medical field. But the burden is probably much higher when you include those who did not seek treatment because they were diagnosed later than necessary and did not receive optimal treatment, Yang said.

“This hospital can provide perfect diagnostic care, but if it takes months to see a doctor in the first place, it slows down the diagnostic stage no matter how good the health system is,” he said.