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Study finds more than 20 percent of patients are misdiagnosed

Research from the Mayo Clinic shows that nearly 88 percent of patients seeking a second opinion go home with a new diagnosis.

Researchers examined records of 286 patients referred by their primary care doctor to the Mayo Clinic’s General Internal Medicine Division in Rochester, Minn., over a two-year period from Jan. 1, 2009 to Dec. 31, 2010.

The referring diagnosis was compared to the final diagnosis to find the amount of consistency between them and the level of diagnostic error. Results showed only 12 percent of the cases had diagnoses confirmed, 21 percent of the diagnosis were completely changed and 66 percent of patients received a refined or redefined diagnosis.

“Effective and efficient treatment depends on the right diagnosis,” James Naessens, a health care policy researcher at the Mayo Clinic, said in a press release. “Knowing that more than 1 out of every 5 referral patients may be completely [and] incorrectly diagnosed is troubling — not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all.”

Several factors may contribute to the amount of misdiagnoses, the researchers said.

Referrals are often limited because health insurers limit access to care outside of their network to keep healthcare costs down. Primary care providers may also be overly confident in their diagnostic expertise than warranted and patients may not have the knowledge or confidence to request a second opinion.

“This may prevent identification of diagnostic error, and could lead to treatment delays, complications leading to more costly treatments, or even patient harm or death,” Naessens said. “We want to encourage second opinions when the provider is not certain.”

The researchers said that, based on the study, more attention and focus need to be placed on the pervasiveness of diagnostic errors.

“Total diagnostic costs for cases resulting in a different final diagnosis were significantly higher than those for confirmed or refined diagnoses, but the alternative could be deadly,” Naessens said.

The study was published in the Journal of Evaluation in Clinical Practice.


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