Misdiagnosis could be as high as 40%

How Common is Misdiagnosis?

Although there is a general feeling that misdiagnosis is quite common, with many people giving anecdotal accounts of their own experiences, it is difficult to get exact data. Whereas there are many studies of adverse drug events and nosocomial infections, there is a relative lack of misdiagnosis studies.

A study of Patient Safety Incidents (PSIs) by HealthGrades found that "Failure to Rescue", meaning failure to diagnose and treat in time, was the most common cause of a patient safety incident, with a rate of 155 per 1,000 hospitalized patients. Unfortunately, the study did not further break down statistics into the types of misdiagnosis, delayed diagnosis or other factors.

The National Patient Safety Foundation (NPSF) commissioned a phone survey in 1997 to review patient opinions about medical mistakes. Of the people reporting a medical mistake (42%), 40% reported a "misdiagnosis or treatment error", but did not separate misdiagnosis from treatment errors. Respondents also reported that their doctor failed to make an adequate diagnosis in 9% of cases, and 8% of people cited misdiagnosis as a primary causal factor in the medical mistake. Loosely interpreting these facts gives a range of 8% to 42% rate for misdiagnoses.

Misdiagnosis rates in the ICU or Emergency Department have been studied, with rates ranging from 20% to 40%. These misdiagnosis rates are likely to be higher than the overall health care misdiagnosis rate because of the time-critical and serious nature of the diagnosis under these crisis conditions.
Malpractice and misdiagnosis: Another interesting fact is that a large proportion of malpractice cases are based on misdiagnosis or delayed treatment of serious conditions. Davenport (2000) lists the top five malpractice-risk conditions in order of prevalence as myocardial infarction, breast cancer, appendicitis, lung cancer and colon cancer, and notes that almost all suits are cases of misdiagnosis or mismanaged diagnostic tests leading to delayed treatment. Myocardial infarction and appendicitis are likely to be related to emergency department visits, whereas the three litigation-prone types of cancers are more common in general physician work.


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