E.R. Doctors Misdiagnose Patients With Unusual Symptoms

According to a new analysis from the federal government, as many as 250,000 people die each year because they are misdiagnosed in the emergency room.

Roughly 7.4 million people are wrongly diagnosed every year in the United States, according to a new study. 370,000 patients are at risk of serious harm.

To quantify the rate of diagnostic errors in the emergency room and identify serious conditions where doctors are most likely to make a mistake, researchers from the university analyzed data from two decades of studies. Some officials of U.S. medical organizations criticized the conclusions of the studies that were based on incidents in Europe and Canada.

When someone presents with symptoms that are not typical, like a stroke patient complaining the room is spinning, they are more likely to have an error.

A doctor may not immediately think that a young woman is having a heart attack or that a person with back pain may have a spine problem.

The author of the study said that the elephant in the room was not being paid attention to.

The need to look harder at where errors are being made is underscored by the findings. He said that it wasn't about blaming emergency room doctors.

Women and people of color have a higher risk of being misdiagnosed. The Society to Improve Diagnosis in Medicine's chief executive said that the results pointed to the need to address how different patients are assessed in the emergency room. She said that equity needs to be core and fundamental.

The study was criticized by medical societies. The president of the American College of Emergency Physicians said that the report made misleading, incomplete and incorrect conclusions.

Diagnostic accuracy of emergency care can be improved. Emergency doctors are committed to improving care and reducing diagnostic error.

It is difficult to address diagnostic errors. While the National Academy of Medicine identified medical errors as a critical issue more than 20 years ago, most of the efforts to improve patient safety have focused on mistakes that are easier to identify. He said that diagnostic errors were a big part of the problem.

According to the report, there are deaths that occur every year. He said the study's findings are higher than before.

The researchers used studies in Canada, Spain and Switzerland to come up with their estimate of error and harm rates. The reliance on these studies may have caused the researchers to overstate the number of mistakes. Emergency medicine doesn't have the same training as other medical specialties.

There needs to be more research on emergency rooms in the United States. One of the study's authors said that studies need to be done in the US. There is a big gap in the literature.

She emphasized the benefit of paying more attention when doctors miss important diagnoses. She said that doctors have become better at detecting heart attacks because of a concerted effort involving public health campaigns, better diagnostic testing, and collaboration between emergency medicine doctors.

While the study focused on emergency rooms where a harried doctor dealing with overcrowding must make a quick decision about what is wrong with a patient, the issue of misdiagnosis is a common problem among all doctors, according to experts.

The board president of the Society to Improve Diagnosis in Medicine said that diagnosis is hard.

Hospitals that teach are less prone to errors. Emergency room doctors working at an academic medical center may be able to consult with a specialist who is familiar with patients who have atypical symptoms, and they may have more resources to offer a wider range of tests or to keep patients longer.

Doctors were more likely to miss certain diseases according to the study. Someone having a heart attack is more likely to be misdiagnosed than a patient with a spine problem.

The answer isn't just to do more testing, warns some doctors. Dr. Wachter said that the problem was a complicated one. He said that the answer can't be to test everyone for everything.

There needs to be more effort to understand how to avoid the most deadly errors, such as thinking about how doctors are trained and what kinds of technology could alert them to a possible missed diagnosis, according to the researchers at the University of Baltimore. Dr. Newman-Toker said that the effort would have to be a sustained one.

Despite its role in improving care, there isn't enough money spent on improving diagnosis. Treatments are the focus of a lot of research dollars. It is more sexy than diagnosis.