795,000 Annual US Deaths and Disabilities Attributed to Misdiagnosis

Written by Vance Voetberg on July 31, 2023. Posted in Current News

Medical misdiagnoses cause 795,000 American deaths or permanent disabilities each year, according to a recent study published in the British Medical Journal

But some medical experts are questioning the legitimacy of the data used in the paper, critiquing the methodology and definition of “diagnostic error.”

The debate highlights the challenges of accurately capturing the prevalence of missed or wrong diagnoses.

Researchers from Johns Hopkins Armstrong Institute Center for Diagnostic Excellence analyzed retrospective data on the top causes of death in the United States, including heart disease, infections, and cancer.

They found just 15 diseases account for about half of all severe medical misdiagnoses, suggesting the problem may be more manageable than previously thought.

“Prior work has generally focused on errors occurring in a specific clinical setting, such as primary care, the emergency department, or hospital-based care,” Dr. David Newman-Toker, a professor of neurology, director of the Center for Diagnostic Excellence, and head researcher, told The Epoch Times.

“These studies could not address the total serious harms across multiple care settings,” he added. In contrast, the new report takes a holistic view, exposing many misdiagnoses across health care.

“We recognize that some may be skeptical about the large estimates,” Dr. Newman-Toker said. For this reason, he said he and his team used nine methods to assess the range of plausible values and cross-validated the results using independent data sources.

“Every method we used produced values roughly between 0.5 and 1.0 million serious harms, so we have a high degree of confidence in our results,” he added.

The Most Commonly Misdiagnosed Conditions

Medical misdiagnoses occur at an estimated 11.1 percent rate among health care providers, according to the report. It’s the subtle symptoms that lead to a misdiagnosis of vascular events, infections, and cancers rather than obvious tumors or irregular heartbeats, Dr. Newman-Toker said.

The most common misdiagnosis occurred in cases of stroke, with 17.5 percent being missed, the report found. This supports previous research, indicating that strokes go undiagnosed due to their diverse and occasionally difficult-to-distinguish symptoms.

A 2018 study published in Neuroepidemiology found that the symptoms of stroke most frequently overlooked include altered mental status, dizziness, and nausea/vomiting.

Strokes are typically treatable with medication in the majority of cases. However, it is crucial to address strokes promptly—within no more than three hours—as they can lead to permanent brain damage and even death.

After stroke, other leading conditions associated with misdiagnoses included sepsis, pneumonia, blood clots, and lung cancer. Together, these five conditions make up 38.7 percent of medical misdiagnoses.

“Reducing diagnostic errors by 50 percent for stroke, sepsis, pneumonia, pulmonary embolism, and lung cancer could cut permanent disabilities and deaths by 150,000 per year,” Dr. Newman-Toker said. “A disease-focused approach to diagnostic error prevention and mitigation has the potential to reduce these harms significantly.”

The Accuracy of These Estimates Questioned

Some experts in the medical field have contested the findings of the Johns Hopkins study.

Dr. Hardeep Singh, a patient safety researcher at the Department of Veterans Affairs and Baylor College of Medicine, questions the paper’s validity.

“The data used to draw these conclusions lack scientific rigor and legitimacy of determining diagnostic error,” Dr. Singh told The Epoch Times. The findings were based on previous studies on medical misdiagnoses, and two prior reports were foundational in making these estimates.

But several flaws were not acknowledged by the authors, Dr. Singh noted.

Problems With Previous Research Used in New Analysis

One of the primary reports referenced in the recent study, which Dr. Singh said had “convenient extrapolations and cherry-picking,” faced significant backlash from the medical community and is currently undergoing re-review by the Agency for Healthcare Research and Quality.

Dr. Singh further highlighted the loose definition of “diagnostic error” used in the recent report. In 2015, the National Academy of Medicine redefined this term to mean “the failure to (a) establish an accurate and timely explanation of the patient’s health problem(s) or (b) communicate that explanation to the patient.”

The goal was to provide “a common understanding of diagnostic error that includes accuracy, timeliness, and communication,” Dr. Singh said. However, many of the studies used to calculate diagnostic error rates were conducted before 2015.

In several of the other studies used for the recent report, the presence or absence of diagnostic error and whether the harm was directly attributable to the error were not clear, he said.

Problems With Analyzing Administrative Data

Another problem with the new report is that its estimates are based on many studies using administrative data, according to Dr. Singh. “It is not possible to make clinical judgments of the presence or absence of error using such data.”

Administrative data is gathered for billing purposes rather than research, and limitations include the potential for inaccuracy and bias. A study published in Medical Care in 2004 analyzed administrative data’s accuracy and revealed that significant inaccuracies, such as diagnostic errors, missing forms, and incorrectly entered data, are common.

The field of diagnostic research should use more robust data to draw conclusions on the rate and harm from medical misdiagnoses, according to Dr. Singh. “When numbers are estimated with potentially flawed data, you lose trust,” he added.

“And making estimates from studies that may not even measure diagnostic errors and sensationalizing them is a fundamental problem that won’t help our case for improvements.”

See more here theepochtimes

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