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Study Suggests ER Doctors Miss, Misdiagnose Dangerous Symptoms

— January 5, 2023

Emergency room diagnostic errors are common, research shows.

A new study suggests that ER doctors misdiagnosed patient symptoms or leave serious issues undiagnosed each year. In fact, the study indicates that this occurs in tens of thousands of patients annually, which leads to a significant loss of life that would have potentially otherwise been avoided if conditions were caught sooner. As many as 250,000 people die every year because they are misdiagnosed by ER doctors, including patients who pass due to strokes, sepsis and pneumonia, according to a new analysis from the federal government.

Researchers from Johns Hopkins University reviewed data from 20 years worth of studies, identifying the diagnostic errors of ER doctors and other serious mistakes. The study was released late last month by the Agency for Healthcare Research and Quality, and researchers estimated that more than 7 million people are inaccurately diagnosed out of the 130 million annual visits to hospital emergency departments in the United States. In addition to the patients losing their lives, another 370,000 potentially suffered serious harm.

Researchers found that errors are most likely to occur when presenting symptoms are atypical of what would normally be expected. Many of the studies reviewed were based on visits in European countries and in Canada, and, as such, officials of U.S. hospital systems have criticized the report.

Study Suggests ER Doctors Miss, Misdiagnose Dangerous Symptoms
Photo by Anna Shvets from Pexels

“In addition to making misleading, incomplete and erroneous conclusions from the literature reviewed, the report conveys a tone that inaccurately characterizes and unnecessarily disparages the practice of emergency medicine in the United States,” Dr. Christopher S. Kang, the president of the American College of Emergency Physicians, said.

However, it is an issue that needs attention because misdiagnosing and leaving serious conditions undiagnosed is a matter of life or death.

“This is the elephant in the room no one is paying attention to,” said Dr. David E. Newman-Toker, a neurologist at Johns Hopkins University and director of its Armstrong Institute Center for Diagnostic Excellence, and one of the study’s authors. “The findings underscore the need to look harder at where errors are being made and the medical training, technology and support that could help doctors avoid them. t’s not about laying the blame on the feet of emergency room physicians.”

The team found that women and people of color had a nearly “20 to 30 percent higher risk of being misdiagnosed.”

“While these results are not surprising, they point to the need to address how different patients are assessed in the emergency room as part of the effort to improve care,” said Jennie Ward-Robinson, the chief executive of the Society to Improve Diagnosis in Medicine. “Equity must be core and must be fundamental.”

“As with all medical specialties, there is room for improvement in the diagnostic accuracy of emergency care,” Dr. Kang added. “All of us who practice emergency medicine are committed to improving care and reducing diagnostic error.”

Of course, the major limitation of the study is the fact that more research needs to be done specifically on the prevalence of the problem in the U.S., something the team did acknowledge.

“We need studies done in the United States,” said Dr. Susan M. Peterson, a Johns Hopkins emergency medicine physician who is also one of the study’s authors. “It’s a huge gap in the literature.”


E.R. Doctors Misdiagnose Patients With Unusual Symptoms

Diagnostic Errors in the Emergency Department: A Systematic Review

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