Report: Three Major Disease Categories Account for Three-Fourths of All Serious Harms from Diagnostic Errors

Researchers, led by an expert from Johns Hopkins Armstrong Institute for Patient Safety and Quality, say that over “100,000 Americans die or are permanently disabled each year due to medical diagnoses that initially miss conditions or are wrong or delayed” and that “three major disease categories account for nearly three-fourths of all serious harms from diagnostic errors.” Their report, originally published in Diagnosis and shared in July by Science Daily, also called diagnostic errors “the most common, most catastrophic and most costly of medical mistakes.”

Researchers call the disease categories (vascular events, infections and cancers) the “Big Three” — those health conditions most likely to be misdiagnosed. According to their findings, which are based on 11,592 medical liability cases between 2006 and 2015, the breakdown of diagnostic errors leading to death or serious, permanent disability were “associated with misdiagnosed cancers (37.8%), vascular events (22.8%) and infections (13.5%).” Specifically, they identify 15 conditions that top the list of serious misdiagnosis-related harms:

  1. Stroke
  2. Sepsis
  3. Lung cancer
  4. Heart attack
  5. Venous thromboembolism
  6. Aortic aneurysm and dissection
  7. Arterial thromboembolism
  8. Meningitis and encephalitis
  9. Spinal infection
  10. Pneumonia
  11. Endocarditis
  12. Breast cancer
  13. Colorectal cancer
  14. Prostate cancer
  15. Skin cancers

In its coverage of the study, Healthleaders reports that “half of the most-severe harm cases ended in patient death and the other half resulted in permanent disability” and that “71% of the diagnostic errors took place in either outpatient clinics or emergency departments.” Quoting the report’s lead author, it says the findings give healthcare organizations “a place to start and real hope that the problem is fixable.”

And that’s exactly what subsequent reports intend to facilitate. Science Daily says the researchers “plan to build on their findings as they continue the phases of their planned three-part study. The next phase will estimate how frequently the 15 most common conditions are misdiagnosed, and the final phase will use nationally representative data sets to derive a population-level estimate of the total number of people in the U.S. harmed by diagnostic error each year.”

What makes physicians and advanced practice providers vulnerable to making these errors is explored in MLMIC’s CME program “High Exposure Liability: Errors in Diagnosis Parts I & II” available on our website. We encourage all providers to enhance their knowledge of this complex issue as part of their ongoing efforts to provide quality medical care to all their patients.

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