False and missed diagnoses lead to the death or permanent disability of 800,000 Americans each year, a shock study suggests.
These medical errors have killed approximately 371,000 people and seriously injured 424,000 people, including brain damage, blindness, loss of limbs or organs, or worsening of cancer.
In a unique study, researchers from Harvard and Johns Hopkins pulled data from dozens of previous studies to find out how often certain conditions are missed and how often this leads to serious harm.
They then extrapolated the finding and applied it to the incidence of new cases in the overall US population.
Researchers behind the study put the number of missed diagnoses at nearly 2.6 million, but that only takes into account the most dangerous diseases like cancer. The actual number of failed diagnoses is likely in the tens of millions.
Report from doctors at Johns Hopkins Medicine and Harvard University suggests false diagnoses may be the leading cause of death due to errors made by medical staff
A missed or incorrect diagnosis often leads a patient to try the wrong kind of treatment without knowing it, only to see no improvement in their condition. A condition such as a stroke, which is missed nearly 18 percent of the time, is often fatal if not addressed immediately
The report suggests that false diagnoses may be the leading cause of death due to errors made by medical personnel.
Physicians at the Johns Hopkins School of Medicine and The Risk Management Foundation at Harvard Medical Institutions collected data from dozens of studies to measure how often diseases were overlooked or misdiagnosed, and how often those misdiagnoses led to serious patient harm.
They repeated that method for 15 specific diseases that cause the most damage: stroke, blood clots in the veins, blood clots in the arteries, aneurysm in an artery, a tear in the arterial wall, heart attack, sepsis, pneumonia, meningitis and inflammation in the brain, an abscess in the spinal cord, and inflammation in the inner lining of the heart valves caused by infection (endocarditis).
In addition, the doctors measured damage from other unspecified problems related to blood vessels, as well as other cancers and infections.
Stroke was one of the conditions most commonly misdiagnosed, with medical professionals missing about 17.5 percent of the time.
Misdiagnoses usually occur when a patient has nonspecific or infrequent symptoms. Some stroke symptoms are very recognizable to doctors, such as a droopy face, slurred speech, and arm weakness, usually in older adults around age 65.
But other stroke symptoms include severe headaches and dizziness, which can easily be confused with another condition. And if the patient with these symptoms is young, doctors may not even consider stroke as the underlying cause.
A missed or incorrect diagnosis often leads a patient to try the wrong kind of treatment without knowing it, only to see no improvement in their condition.
Lindsay Cohen Karp, 39, a children’s book author from Philadelphia, struggled with years of debilitating fatigue and pain throughout her body that left her unable to walk. Still, medical professionals couldn’t figure out what was going on.
It took 13 years of searching for answers and trying different approaches, from psychotherapy to a mixed cocktail, before a doctor finally saw white spots on an MRI that indicated to him that her immune system had eaten away at the protective covering of her nerves, disrupting the communication between her brain and her body. Mrs. Karp had multiple sclerosis.
Lindsay Cohen Karp, 39 of Philadelphia, who has multiple sclerosis, says she was misdiagnosed for 13 years and was told by doctors to “exercise” or make a “mixed drink” to ease her severe pain
The chart shows findings from researchers at Johns Hopkins University who examined 279 studies from January 2000 to September 2021 to calculate the rate of diagnostic errors and select the conditions that most often slip under doctors’ radars
Thanks to this single doctor and the MRI he prescribed, Lindsay was able to get the right medication for her condition, returning her body to “what it once was.” And while she still has flare-ups, she said she “finally recognizes herself again.”
Ms Karp added: ‘Without him I would certainly still be undiagnosed, unable to walk and have no stamina to continue. Without him my boys wouldn’t have a mother.’
A few years earlier, Miami native Jessica DeCristofaro, 28, was told her persistent three-year bout of severe coughing was due to allergies — and she was prescribed medication and advised to change her diet.
But in January 2016, after experiencing severe abdominal pain that her doctors thought was acid regurgitation or an ulcer, Ms. DeCristofaro was told in the emergency room that scans and blood tests revealed she had advanced-stage Hodgkin lymphoma — a rare cancer that develops in the lymphatic system, a network of blood vessels and glands located throughout the body.
The error rate calculated by the doctors at Hopkins and Harvard varied widely by condition.
For example, doctors misdiagnose a spinal abscess, a condition often caused by bacterial infections that spread from other parts of the body through the bloodstream to the spine, 62 percent of the time, while a heart attack was misdiagnosed less than 2 percent of the time.
Overall, they estimate that doctors miss 11 percent of diagnoses, making this a “pressing public health problem,” according to the study authors.
Dr. David Newman-Toker, the lead researcher in the study and a neurologist at Johns Hopkins said: ‘A disease-focused approach to preventing and reducing diagnostic errors has the potential to significantly reduce this harm.
“Reducing diagnostic errors by 50% for stroke, sepsis, pneumonia, pulmonary embolism and lung cancer could reduce permanent disability and deaths by 150,000 per year.”
But they added that patients should be so wary of misdiagnoses that they lose faith in the medical system, which for all its shortcomings poses a low overall risk of something going terribly wrong.
They said, “Given the more than 1 billion medical visits a year in the US, a patient who sees a doctor for any reason (i.e. whether or not a dangerous underlying disease) is likely to have a [less than one percent] risk of serious misdiagnosis-related damage.’
The findings were published this week in the journal BMJ quality and safety.