Diagnosing Misdiagnosis

A recent piece in the Journal of the American Medical Association caught our attention. The article, by Dr. David Newman and Dr. Peter Provonost, focused on the “next frontier” of patient safety: diagnostic errors.

As the authors explain, the medical community has focused far more of its attention on treatment errors instead of on misdiagnosis-related harm. For instance, “A 2003 report of 93 AHRQ [Agency for Healthcare Research and Quality]-funded patient safety projects found only 1 focused on misdiagnosis.”

Given the numbers the authors cite, overlooking diagnostic mistakes is troubling. The authors explain that an alarming “40,000 to 80,000 US hospital deaths result from misdiagnosis annually.” One out of every 20 autopsies “reveal lethal diagnostic errors for which a correct
diagnosis coupled with treatment could have been averted.”

The authors go on to suggest several solutions to the problem. By and large, they call for a reassessment of the systems used for diagnosis, such as computerized diagnostic support systems, re-categorization of adverse-event data for better analysis, and building physician buy in for the solutions that are finally adopted.

The take-home lesson from a new focus on better diagnosis is that the mistaken diagnosis is, unfortunately, a common contributor to unnecessary adverse events in the hospital, including deaths. These preventable mistakes result in avoidable harm to surviving family members and loved ones.