False and missed diagnoses are killing or permanently disabling 800,000 Americans each year, an impact study suggests.
These medical errors cost an estimated 371,000 lives and 424,000 serious injuries, including brain damage, blindness, loss of limbs or organs, or worsening cancer.
In a one-of-a-kind study, Harvard and John’s Hopkins researchers pulled data from dozens of previous studies to determine how often certain conditions are missed and how often this leads to serious harm.
They then extrapolated and applied the finding to the incidence rate of new cases in the total US population.
The researchers behind the study estimated the number of missed diagnoses to be closer to 2.6 million, but that only considers the most dangerous diseases, such as cancer. The actual tally of missed diagnoses probably runs into the tens of millions.
The report by doctors from Johns Hopkins Medicine and Harvard University suggests that false diagnoses could potentially be the leading cause of death due to errors made by medical personnel.
A missed or misdiagnosis often results in a patient trying the wrong type of treatment without even knowing it, only to see no improvement in their condition. A condition like a stroke, which is missed nearly 18 percent of the time, is often fatal if not treated immediately.
The report suggests that false diagnoses could potentially be the biggest cause of death due to mistakes made by medical personnel.
Doctors at the Johns Hopkins School of Medicine and the Harvard Medical Institutions Risk Management Foundation collected data from dozens of studies to measure how often diseases were missed or misdiagnosed, and how often that misdiagnosis 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 inside the arteries, aneurysm in an artery, tear in the artery wall, heart attack, sepsis, pneumonia, meningitis and inflammation in the brain, spinal cord abscess, and inflammation of the inner lining of the heart valves caused by an infection (endocarditis).
In addition, the doctors measured damage resulting from other unspecified problems related to blood vessels, as well as other types of cancer and infections.
Stroke was one of the most frequently misdiagnosed conditions, missed about 17.5 percent of the time by medical professionals.
Misdiagnoses usually occur when a patient has non-specific or rare symptoms. Some stroke symptoms are highly recognizable to doctors, such as face drooping, slurred speech, and arm weakness, most often in older adults around age 65.
But other symptoms of a stroke include severe headaches and dizziness, which can easily be mistaken for another condition. And if the patient presenting with these symptoms is young, doctors may not even consider stroke to be the underlying cause.
A missed or misdiagnosis often results in a patient trying the wrong type of treatment without even knowing it, only to see no improvement in their condition.
Lindsay Cohen Karp, 39, a children’s book author from Philadelphia, dealt with years of debilitating fatigue and pain throughout her body, leaving her unable to walk. However, medical professionals were unable to figure out what was wrong.
It took him 13 years of searching for answers and trying different approaches, from psychotherapy to mixed cocktails, before a doctor finally noticed white spots on an MRI that told him his immune system had been eating away at the protective covering of his nerves, disrupting communication between his brain and body. Ms. Karp had multiple sclerosis.
Lindsay Cohen Karp, 39, of Philadelphia, who has multiple sclerosis, says she was misdiagnosed for 13 years and told by doctors she should “exercise” or make herself a “mixed drink” to ease her severe pain.
The graph shows the findings of researchers at John Hopkins University who examined 279 studies from January 2000 to September 2021 to calculate the rate of diagnostic errors and select the conditions most often missed by doctors.
Thanks to this one doctor and the MRI he prescribed, Lindsay was able to get the right medication for her condition that helped her body go back to “what it was before.” And though she still has breakouts, she said that she “finally recognizes herself again.”
Ms Karp added: ‘Without it, I would surely still be undiagnosed, unable to walk and without energy to continue. Without him, my children would have no mother.
A few years earlier, Jessica DeCristofaro, 28, a Miami native, was told her persistent bout of severe coughing for three years was due to allergies, and was prescribed medication and advised to change her diet.
But in January 2016, after suffering severe abdominal pain that her doctors believed was acid reflux or a stomach 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 vessels and glands throughout the body.
The error rate that the Hopkins and Harvard doctors calculated varied greatly by condition.
For example, doctors misdiagnose a spinal abscess, a condition often caused by bacterial infections that spread to the spine from other parts of the body through the bloodstream, 62% of the time, while a heart attack is misdiagnosed less than 2% of the time.
Overall, they estimated that doctors miss 11 percent of diagnoses, making this a “pressing public health problem,” according to the study authors.
Dr. David Newman-Toker, study principal investigator and a Johns Hopkins neurologist saying: ‘A disease-focused approach to the prevention and mitigation of diagnostic errors has the potential to significantly reduce these harms.
“Reducing diagnostic errors by 50% for stroke, sepsis, pneumonia, pulmonary embolism and lung cancer could reduce permanent disabilities and deaths by 150,000 per year.”
But they added that patients need to be so careful about misdiagnoses that they lose trust in the medical system, which, for all its flaws, presents an overall low risk of something going terribly wrong.
They said: “Given the more than 1 billion health care visits per year in the US, a patient who sees a doctor for any reason (that is, they may or may not have a dangerous underlying condition) probably has a [less than one percent] potential for serious harm related to misdiagnosis.’
The findings were published this week in the journal BMJ quality and safety.