Diagnostic error is common and dangerous. Recent studies look at diagnosis in the Emergency Department (ED), and what factors can influence misdiagnosis.
According to a recent statement from the Agency for Healthcare Research and Quality (AHRQ), overall accuracy of diagnosis is fairly high in the US. Responding to criticism of a recent agency study, AHRQ notes there are about 130 million ED visits each year in the US. Of those, approximately 7.4 million (5.7 percent) are misdiagnosed. While that percentage could be considered relatively low by some, for the unfortunate patients who are misdiagnosed, the consequences can be dire. That works out to about one in every 18 patients seen in an American ED.
At the top of the list of ED conditions which are more commonly misdiagnosed in the ED are:
- Stroke
- Heart attack (myocardial infarction)
- Aortic aneurism/dissection
- Spinal cord compression
- Venous thromboembolism (blood clot in the veins)
One issue behind misdiagnosis is the presentation of symptoms that are uncommon for a known disease, such as appendicitis. Although symptoms of appendicitis can vary by age group, a patient that presents with sharp left-sided pain, pain on urination, or constipation, with no other symptoms may not be diagnosed correctly with appendicitis. A certain percentage of misdiagnosed patients are those who suffer symptoms not consistent with the typical presentation of the condition they are suffering.
Factors that can contribute to a misdiagnosis include:
- Experiencing atypical symptoms and vague physical complaints can contribute to misdiagnosis.
- For those suffering stroke, dizziness and vertigo increase the risk of misdiagnosis by 14 times (as opposed to motor symptoms).
- Age at presentation has an impact. Younger patients suffering stroke are more likely to be misdiagnosed, while older adults may experience a missed diagnosis of appendicitis.
- Being non-white and female might boost the odds of an incorrect diagnosis in some settings.
- Misdiagnosis rates are often lower in teaching hospitals.
- The strongest predictive factor in ED misdiagnosis is presenting with symptoms uncommon for that condition or symptoms that are sporadic or mild.
Communication between patient and caregiver is critical to creating a workable diagnosis. Too often, ED providers are rushed, diagnostic imaging equipment not be immediately available due to overcrowding, and language barriers or other challenges may prevent a patient from clearly describing their condition and symptoms.
No healthcare provider intends to provide sub-par care, or contribute to a misdiagnosis. But it happens too often. If you are injured through a missed, inaccurate, or delaying diagnosis—speak with our legal team.
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