New research confirms that diagnostic errors are the most common, most catastrophic, and most costly of serious medical errors. Yet, we now have a better understanding of which conditions cause the majority of incidents of serious patient harm resulting from misdiagnosis.
By David E. Newman-Toker
According to a recent study published in the journal Diagnosis, roughly one in three malpractice cases involving serious harm to a patient – those that result in permanent disability or death – is due to an inaccurate or delayed diagnosis. Researchers analyzed more than 55,000 malpractice claims from CRICO Strategies’ CBS database (Comparative Benchmark System) to better understand diagnostic errors. The analysis found that nearly three-quarters of diagnostic errors resulting in serious patient harm involved misdiagnosed cancers, vascular events (like strokes), or infections (including sepsis). Fifteen specific diseases, representing the top five in each category, account for nearly half of all serious harm cases.
“Given the findings of the research, if we can improve diagnosis of cancers, infections, and vascular events, we’ll be able to drastically reduce the overall burden of serious patient harms from inaccurate and delayed diagnoses,” said David Newman-Toker, MD, PhD, professor of neurology at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality’s Center for Diagnostic Excellence. Dr. Newman-Toker also is President of the Board of the Society to Improve Diagnosis in Medicine.
Dedicated federal spending on research to eliminate harm caused by inaccurate and delayed diagnoses is small in relation to the resulting public health burden – both human and financial. Last year the United States Congress added $2 million in federal research funding to address this problem. According to the researchers behind the study, this is a small but important step in the right direction, given that the US spends a baseline amount of less than $10 million on this issue each year. However, the new total for diagnostic errors is still less than is spent each year on smallpox research – a disease eradicated in the US over half a century ago. To find real solutions to tackle this $100+ billion problem, far more support – by several orders of magnitude, and sustained over time – is needed.
The study represents a big leap forward in our understanding of where, why, and in which conditions inaccurate or delayed diagnoses occur, leading to serious patient harm. More research to identify, test and implement solutions to prevent these harms is now necessary.
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David E. Newman-Toker, Adam C. Schaffer, Chihwen Winnie Yu-Moe, Najlla Nassery, Ali S. Saber Tehrani, Gwendolyn D. Clemens, Zheyu Wang, Yuxin Zhu, Mehdi Fanai, Dana Siegal: Serious Misdiagnosis-Related Harms in Malpractice Claims: The “Big Three” – Vascular Events, Infections, & Cancers, 11.07.2019.