One in seven medical diagnosis incorrect

The estimated 140,000 diagnostic errors made in Australia every year could be prevented by implementing key strategies, according to a perspective paper by a University of Queensland researcher.

UQ’s Professor Ian Scott said statistics have revealed around 21,000 cases of misdiagnosis made in a clinical setting involved serious harm, and up to 4000 resulted in death.

“Almost one in two malpractice claims brought against general practitioners also involved diagnostic error,” Professor Scott said.

“Cognitive factors in clinician decision making are the primary or contributing cause of more than 75 per cent of diagnostic errors.

“More than 80 per cent of these cases are preventable.”

Professor Scott has identified several key strategies for reducing cognitive errors based on information derived from a number of research studies around the world.

“By using lectures, seminars, group discussion and interactive videos, clinicians can be prompted to consider a broader range of diagnostic possibilities,” he said.

“Diagnostic checklists can be used to remind clinicians to systematically evaluate alternatives before making a diagnosis.

“Also, clinicians can be asked to articulate out loud their reasoning for a diagnosis as the case unfolds, and trained to ‘think about their thinking’ and reflect on past diagnostic mistakes.”

Other strategies Professor Scott has identified from research papers include encouraging clinicians to seek a second opinion prior to making a diagnosis, and following up with patients and reviewing cases involving an adverse patient event.

He said computer-assisted diagnosis can be used where appropriate, and clinicians should ask patients if a diagnosis corresponds with how they perceive their illness.

“The prevalence of incorrect diagnosis and harm caused to patients were important factors in calling for clinicians to consider preventive strategies,” Professor Scott said.

Professor Scott’s perspective paper, written in conjunction with Associate Professor Carmel Crock, Director of Emergency Department at the Royal Victorian Eye and Ear Hospital, is published in the Medical Journal of Australia. (DOI: 10.5694/mja2.50771)

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