What accounts for diagnostic errors in the emergency department? Elizabeth Tracey reports


Your chance of having a diagnosis missed when you visit an emergency department is 5.7%, an Agency for Healthcare Research and Quality study led by David Newman-Toker at Johns Hopkins has found. Newman-Toker says further analysis revealed the kinds of issues that most often resulted in a missed diagnosis.

Newman-Toker: If your symptoms are atypical or they’re subtle or it’s occurring in the wrong demographic group, so you’re a young patient with stroke when stroke is supposed to be a disease of the elderly, or you’re an older patient with appendicitis when that’s supposed to be a disease of the young. Those sorts of things all make the degree of difficulty in making the correct diagnosis higher, and it's not unexpected then that in those kinds of contexts we’ll be more likely to miss the diagnosis.  :25

Newman-Toker notes that even when the diagnosis was missed, the chance of an adverse event as a result was about 2%, with 0.3% of these events as serious or life-threatening. He says the study points to only 15 conditions that are most often problematic, so a path to improvement is clear. At Johns Hopkins, I’m Elizabeth Tracey.