ER doctors misdiagnose patients with unusual symptoms

Doctors fail to recognize serious illnesses like strokes and sepsis in tens of thousands of patients every year, new research finds .

Up to 250,000 people die each year because they are misdiagnosed in emergency rooms, as doctors fail to identify serious medical conditions like stroke brain, sepsis and pneumonia, according to a new federal government analysis.

The study, published Thursday by the Agency for Research and Quality in Healthcare, estimates that around 7.4 million people are diagnosed as inaccurate about the 130 million annual visits to hospital emergency departments in the United States. Some 370,000 patients could be seriously affected.

Researchers at Johns Hopkins University, under contract with the agency, analyzed data from two decades of studies to quantify the rate of misdiagnosis in the emergency room and identify serious conditions where doctors are most likely to make an error. Many studies were based on incidents in European countries and Canada, which led some officials of American medical organizations to criticize the researchers' conclusions.

Although these errors are still relatively rare, they are more likely to occur when a person has symptoms that are not typical, such as stroke patients complaining that the room is spinning.

A doctor may not immediately suspect that a young woman with shortness of breath is having a heart attack or that a person with back pain might have a spinal abscess.

"It's the elephant in the room, nobody cares," said Dr. David E. Newman-Toker, a neurologist at Johns Hopkins University and director of his Armstrong Institute Center for Diagnostic Excellence, and one of the study authors.

< p class="css-at9mc1 evys1bk0"> The findings underscore the need to take a closer look at where mistakes are made and the media medical education, technology and support that could help doctors avoid them, the report said. Dr. Newman-Toker. "It's not about laying the blame on the feet of ER doctors," he said.

In reviewing the studies, researchers have also found that women and people of color had about a 20 to 30 percent higher risk of being misdiagnosed. While these findings are not surprising, they underscore the need to address how different patients are assessed in the emergency department as part of the effort to improve care, said Jennie Ward-Robinson, chief executive of the Society to Improve Diagnosis in Medicine. "Equity must be essential and must be fundamental," she said.

Medical societies representing emergency physicians strongly criticized the study. "In addition to drawing 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," said Dr. Christopher S Kang, president of the American College of Emergency Physicians, said in a statement. . "All of us who practice emergency medicine are committed to improving care and reducing misdiagnosis."

Doctors say it's hard to treat diagnostic errors. While the National Academy of Medicine identified medical errors as a critical problem more than 20 years ago, most efforts to improve patient safety have focused on errors that are easier to identify, such as when a patient receives the wrong medication or develops an infection while in the hospital, said Dr. Robert Wachter, chair of medicine at the University of California, San Francisco, who had not seen the full report. "Misdiagnosis is a big part of the problem," he said.

The deaths that the report says occur every year "are a very concerning number," Dr Wachter said. said. There ...