Researchers say cancers, infections, and vascular events are often misdiagnosed. Here’s what you can do to help reduce that risk.
Each year, an estimated 100,000 people in the United States die or are permanently disabled due to a diagnosis that was either missed or delayed.
Misdiagnoses are the most common, costly, and dangerous of medical mistakes. They continue to be a serious issue in the United States.
Now, new research from Johns Hopkins University in Maryland has identified the three major disease categories — infections, vascular events, and cancers — that are most frequently linked to serious and life-threatening diagnostic errors.
Deemed “The Big Three” by the researchers, these types of health conditions account for about 75 percent of misdiagnoses-related harms, according to the new study published in the journal Diagnosis.
The findings suggest that most serious harm cases link back to a small handful of conditions.
Researchers say they hope the information can help the medical community find new solutions to reduce the amount of diagnostic errors that occur over the next decade.
“I think the learning points are that medical professionals need to engage in lifelong learning to ensure their knowledge bases remain current; that careful attention to the patient’s complaints coupled with medical decisions that are based on high-quality evidence is central to avoiding misdiagnosis; and that no matter how advanced is the level of our medical and technical knowledge, mistakes will always happen,” Dr. Edward Damrose, an otolaryngologist and the chief of staff at Stanford Health Care, told Healthline.
The researchers evaluated 11,592 diagnostic error cases between 2006 and 2015 from a list of malpractice claims compiled in the national Comparative Benchmarking System database.
While diagnostic errors occur across all health categories, the team found that nearly three-fourths of serious errors were affiliated with cancers (37 percent), vascular events (22 percent), and infections (13 percent).
The team identified 15 conditions that account for about half of all of the severe misdiagnosis-related harms.
Stroke, sepsis (a blood infection), and lung cancer were most commonly misdiagnosed.
These were followed by heart attack, severe blood clots, meningitis, and encephalitis, along with breast, prostate, and skin cancers.
The most common reasons for the errors were related to clinical judgment failures — such as failing to order a diagnostic test or consultation, having too narrow of a diagnostic focus, failing to properly evaluate relevant symptoms or test results, and misinterpreting diagnostic test results.
Finally, the study found that most misdiagnoses — about 71 percent — occurred in ambulatory settings.
Cancer misdiagnoses were most likely to occur in an outpatient clinic, whereas infection and vascular-related diagnostic errors were most likely to take place in emergency departments.
Some conditions are inherently tricky to diagnose, especially early in their course, according to health experts.
For example, many people with lung cancer will first come to their doctors with a cough — something that’s frequently seen with a respiratory infection or the common cold, according to Damrose.
“In the absence of telling additional symptoms or history — for example, a history of smoking, the presence of blood in the sputum, or weight loss — a case of lung cancer where a cough is that only presenting symptom could easily be mistaken for something more innocuous, like an allergy,” Damrose said.
Infections can also be difficult to figure out and often require multiple hospital visits to nail down the right diagnosis.
“The patient presentation [of infection] is widely variable and sometimes indolent with progression over time, making diagnosis from a single physician encounter difficult,” said Dr. Danielle Bajakian, a vascular surgeon with Columbia University Irving Medical Center in New York.
With vascular events — such as a TIA, or stroke — early diagnosis and treatment is crucial. However, many are missed at first, Bajakian told Healthline.
Looking forward, it may be necessary to develop new systems and solutions to helps doctors sharpen clinical diagnoses.
This may include anything from devices that provide decision support, improvements to diagnostic education, and more immediate access to specialists, perhaps via tele-consultation, according to the researchers.
There are many things people can do to ensure they get an accurate diagnosis, according to Dr. Anees Chagpar, a breast surgical oncologist with Yale Medicine in Connecticut.
First and foremost, it’s crucial to find a healthcare provider that regularly works with your health condition.
“If yours is an issue that is rare, often the larger academic institutions have people with specialized expertise that may be better able to deal with your issue,” Chagpar told Healthline.
In addition, always consider getting a second opinion, even if it’s just to confirm what your doctor suggests.
When you do go for that additional opinion, get another read of your radiology films, pathology slides, and test results.
“Interpretation of this data is critical to obtaining a diagnosis, and the radiologists and pathologists at one institution may not always agree with those at another,” Chagpar said.
Lastly, seek out healthcare facilities where there’s more than one specialist in each discipline. That way, your case can be discussed and reviewed by multiple people who can come up with a consensus.
Keep in mind, though, that some conditions are difficult to diagnosis. But, still, do your research, ask questions, and don’t give up until you get some answers.
“At the end of the day, however, some diagnoses are difficult to make even in the most experienced hands. But you can do everything you can to ensure that your diagnosis is accurate, and your treatment is tailored to you,” Chagpar said.
New research has identified the three major disease categories — infections, vascular events, and cancers — that are most frequently linked to serious and life-threatening diagnostic errors.
Misdiagnosis is a major issue in the United States with an estimated 100,000 people dying or becoming permanently disabled due to a misdiagnosis each year.
Looking forward, researchers hope this information can help healthcare systems improve their diagnostic decision-making to significantly reduce the amount of misdiagnoses within the next decade.