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Most diagnostic errors result from the ‘Big 3’ categories

More than 100,000 Americans die each year due to medical diagnoses that are incorrect, delayed or missed entirely. But researchers at Johns Hopkins say a surprisingly small number of conditions account for the vast majority of those medical mistakes.

Three major disease categories – cancers, infections and vascular events – comprise the so-called “big three” of diagnostic errors. While medical science lists more than 10,000 diseases, researchers say the big three accounts for roughly 75% of diagnosis-related claims in medical malpractice lawsuits.

More than half of all mistakes are related to 15 conditions

The Johns Hopkins research team studied information from more than 90,000 patients, for whom diagnosis mistakes were fatal or led to permanent, severe disability. The percentage of errors related to each big three categories were:

  • Cancers: 38%
  • Vascular events: 23%
  • Infections: 13%

Scientists drilled down even further, identifying 15 ailments responsible for over 50% of all diagnostic errors. These conditions are:

  • Stroke
  • Sepsis
  • Lung cancer
  • Heart attack
  • Breast cancer
  • Colorectal cancer
  • Prostate cancer
  • Skin cancer
  • Blood clots in veins and arteries
  • Aortic aneurysms
  • Arterial thromboembolism
  • Meningitis and encephalitis
  • Spinal infection
  • Pneumonia
  • Endocarditis

Health care systems must help improve bedside diagnoses

After scouring patient data, Johns Hopkins researchers found that 85% of the misdiagnosed cases resulted from poor judgment by clinical providers. The authors say this adds to the growing evidence that hospitals and other health systems must focus on patient safety efforts.

Those methods include digital diagnostic support tools, better utilization of specialists, providing a more effective team environment, improving patient engagement, simulation training to improve diagnostic education and providing regular feedback for doctors and other health care staff.

Source: Polyniak K. (Fall 2019). The ‘Big 3’ in Diagnostic Errors. Johns Hopkins Medicine.