When a doctor makes a mistake in diagnosis, the results can have “devastating consequences,” says a new Report by the Institute of Medicine, calling for a major effort to improve the work of detecting and treating disease.
“Most people will experience at least one diagnostic error in their lifetimes, said the report, “Improving Diagnosis in Health Care.”
“Postmortem examination research spanning decades has shown that diagnostic errors contribute to approximately 10 percent of patient deaths, and medical record reviews suggest that they account for 6 to 17 percent of adverse events in hospitals,” the September 22 report said.
Researchers have studied medical mistakes in various ways: looking at charts from doctors offices to review the initial diagnosis and then the follow-up treatment, or the lack of treatment. They also use formulas to review the frequency of visits. Sometimes a missed diagnosis or a wrong one may be followed by unexpectedly frequent visits or hospitalizations after it becomes clear that a serious condition was overlooked.
Patients can suffer in many ways: physically, emotionally and financially, the report noted. ” Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions.”
A 2014 study estimated that 12 million adults suffered a diagnostic mistake at doctors’ offices, an error rate of 5%. “Based upon previous work, we estimate that about half of these errors could potentially be harmful,” said the authors, led by Dr Hardeep Singh of the VA Medical Center in Houston.
The problem is urgent and calls for a determined effort at improvement, the IOM said. “Urgent change is warranted to address this challenge. Improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers.”
But progress has been scant, despite the sounding of similar alarms in the past. In 1999, the Institute of Medicine issued a report, “To Err is Human: Building a Safer Health System. ”
The report called for improved safety and diagnostic accuracy, estimating that between 44,000 and 98,000 people died each year because of preventable medical errors.
