A recent study shows at least one in 20 adults who seek care at an outpatient health care clinic is misdiagnosed. Such diagnostic errors affect an estimated 12 million patients nationwide, according to the analysis published online in BMJ Quality & Safety.
While diagnostic errors are some of the most common medical mishaps, studying their source has proved difficult in the past. For the BMJ analysis, the authors examined three previous studies that used electronic triggers to detect unusual patterns of return patient visits or lack of follow-up after abnormal clinical findings. In all three studies, diagnostic errors were confirmed through a chart review. Researchers determined that the rate of outpatient diagnostic mistakes was 5%, suggesting that 12 million patients are impacted by such errors every year. About half of the errors were potentially harmful.
Researchers noted that patient safety improvements are frequently aimed at hospital stays and at issues such as infections, falls and medication errors. However, the study shows that many diagnostic errors are made in outpatient clinics in which patients are examined by different health care providers.
The BMJ study correlates with other recent studies analyzing outpatient errors. In a 2004 study published in Annals of Family Medicine, researchers found that of 351 outpatient visits, 24% of visits ended in errors and poor outcomes. Nearly 25% of the errors resulted in harm to the patients, and harm was a potential in another 70% of errors, according to the Annals study. In a Harvard Medical Practice study, results showed diagnostic errors accounted for 17% of preventable errors in hospitalized patients. Meanwhile, a systematic review of autopsy studies found that 9% of patients had experienced a major diagnostic errors that went undetected while the patient was still alive.
BMJ study authors stress that healthcare organizations, patient advocates, policymakers, and researchers should use the findings to push for further strategies to improve patient safety in the outpatient arena.
Misdiagnoses can result in serious harm in patients and/or death. Patients and their loved ones should speak up if they believe they have been misdiagnosed. Diagnostic errors that seriously injury patients can be a form of medical malpractice.