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Researchers find 5% misdiagnosis rate in outpatient settings

Sunday April 20, 2014
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At least 1 in 20 adults is misdiagnosed in outpatient clinics in the U.S. every year, amounting to 12 million people nationwide, and posing a “substantial patient safety risk,” according to a study.

Half these errors are potentially harmful, according to the authors, who add that their findings should prompt renewed efforts to monitor and curb the numbers of misdiagnoses.

To date, patient safety improvements have largely focused on hospital stays and issues such as infections, falls and medication errors, according to background information in the study, which was published April 17 on the website of BMJ Quality & Safety. But most diagnoses are made in outpatient clinics, where patients are looked after by several different healthcare teams and few safety concerns are reported. Prioritizing strategies to reduce misdiagnosis rates has been difficult because of the lack of reliable estimates of those rates.

In a bid to gauge the numbers of diagnostic errors made in U.S. outpatient clinics every year, Hardeep Singh, MD, MPH, of the Michael E. DeBakey VA Medical Center and the Baylor College of Medicine, Houston, and colleagues combined data from several published studies that involved hundreds of medical records, sampled from a large pool of outpatient clinic visits.

This approach overcomes many of the challenges inherent in making similar assessments from malpractice data, autopsy reports or specialized fields of medicine, the authors noted.

The records were reviewed in detail to determine whether a diagnostic error had been made. The proportion of errors found was then applied to the larger population of all outpatient visits and then to the U.S. adult population as a whole to estimate the annual frequency of misdiagnoses. Based on these data, the authors calculated the numbers of new cases of misdiagnoses at 5.08%.

Healthcare organizations, patient advocates, policymakers and researchers should use the findings to push for further strategies to improve patient safety in this area, the authors concluded.

Study abstract: http://qualitysafety.bmj.com/content/early/2014/04/04/bmjqs-2013-002627.short


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