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New Report Finds About 12 Million Outpatients Misdiagnosed Annually in U.S.

Published studies provide data on diagnostic errors

Diagnostic errors — missed opportunities to make a timely or correct diagnosis based on available evidence — occur in about 5% of adults in the U.S., according to a new study led by a researcher at Baylor College of Medicine. The study, published online April 17 in BMJ Quality & Safety, estimates that approximately 12 million adults in the U.S. could experience an outpatient diagnostic error each year.

“The findings of this study are consistent with recent data from the general public about diagnostic errors,” said lead investigator Dr. Hardeep Singh. “This study is significant because it is based on a large sample size and is the most robust estimate thus far to address the frequency of diagnostic error in routine outpatient care.”

Data sources included two previous studies that used electronic triggers, or algorithms, to detect unusual patterns of return visits after an initial primary care visit or the lack of follow-up of abnormal clinical findings related to colorectal cancer, both suggestive of diagnostic errors. A third study examined consecutive cases of lung cancer. In all three studies, diagnostic errors were confirmed through chart reviews and were defined as missed opportunities to make a timely or correct diagnosis based on available evidence. These data provided the authors of the new study with an estimated frequency of diagnostic error. This frequency was then applied to the general adult population.

“Keeping patients safe begins with a correct and timely diagnosis,” said Dr. Richard Kronick, director of the Agency for Healthcare Research and Quality. “Diagnostic errors made in outpatient care can be difficult to measure, and this is a relatively new area for patient safety researchers. Health care professionals are typically accurate in making diagnoses, but finding ways to improve diagnoses and to eliminate errors is an important goal. This study helps us better understand the extent of the problem and focus our efforts on reducing the harm to patients.”

Diagnostic errors can harm patients by delaying their treatment, the authors say. For example, a delayed or incorrect cancer diagnosis could make the disease harder to treat or more deadly.

“Misdiagnosis is clearly a serious problem for the health care field,” said Singh. “This population-based estimate should provide a foundation for policymakers, health care organizations, and researchers to strengthen efforts to measure and reduce diagnostic errors.”

Sources: Baylor College of Medicine; April 17, 2014; and BMJ Quality & Safety; April 17, 2014.

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