The cost of diagnostic errors in the ER: 5 study notes

A new study led by the Agency for Healthcare Research and Quality that estimates 370,000 patients may suffer serious harm as a result of misdiagnosis in U.S. emergency departments every year is being met with strong criticism from medical societies representing emergency physicians, The New York Times reported Dec. 15. 

Researchers from Baltimore-based Johns Hopkins University worked with the AHRQ to analyze data from studies dating to 2000 to estimate the prevalence and effect of diagnostic errors in the ER. Many of the studies in the review were conducted outside of the U.S., in "developed countries deemed comparable by a technical expert panel," which has led many medical organizations in the U.S. to question the estimates. 

Five notes: 

1. The study estimates that among 130 million ED visits per year in the U.S., 7.4 million patients are misdiagnosed and some 370,000 may suffer serious harm or death. 

2. Serious diagnostic errors were more likely to occur when patients presented with atypical symptoms, such as stroke patients experiencing dizziness or vertigo. 

3. Stroke, myocardial infarction, aortic aneurysm/dissection, spinal cord compression/injury and venous thromboembolism accounted for 39 percent of serious misdiagnosis-related harms. 

4. Researchers found women and people of color were associated with between a 20 percent and 30 percent higher risk of misdiagnosis. 

5. The study was met with criticism from the American College of Emergency Physicians, whose president called the conclusions "misleading, incomplete and erroneous," and said the reliance on studies conducted outside of the U.S. may have led to overestimates of mistakes. In a statement to the Times, the group's president, Christopher Kang, MD, said, "The report conveys a tone that inaccurately characterizes and unnecessarily disparages the practice of emergency medicine in the United States," and, "While most medical specialties have similar training in Western nations, emergency medicine does not."

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