Study: Misdiagnosis occurs in 1 out of Every 20 Outpatients

outpatient_misdiagnosis_studyA new study suggests that at least 1 in every 20 outpatients-those who receive care without being admitted to a hospital-experience a misdiagnosis. The study, which was published in the journal BMJ Quality & Safety, found that the rate of misdiagnosis in outpatients was about 5 percent. This translates to 1 in 20 adults, 12 million people when applied to the entire US population.

The study was led by Dr. Hardeep Singh, a researcher at the Michael E. DeBakey VA Medical Center in Houston, Texas and an associated professor at Baylor College of Medicine Safety. Singh used data from three of his previous studies to analyze the rates of misdiagnosis in outpatients. The first study looked at misdiagnoses in primary care, while the second and third focused on misdiagnoses in lung and colon cancer patients, respectively. Misdiagnoses were characterized when patients presented clear symptoms that were not noticed or not properly followed up on. Researchers said that about half of the missed diagnoses could have a harmful impact on the patient’s health.

“We called it a misdiagnosis when there was a definite missed opportunity to make a timelier, correct diagnosis based on information available at that time,” said Dr. Singh to “We would say, ‘Was that opportunity there? Was evidence there? Was it someone who presented with a red flag for colon cancer, who didn’t get a work up?”

Dr. Singh also pointed out that few studies look at the quality of outpatient care. “In some ways, in outpatient [care], it’s challenging; patients move between different systems of care, specialists, radiologists,” he said “We had done studies in integrated health care systems and thought it would be good to extrapolate that data to see how commonly these things are occurring, to see what needs to be done about them. And the numbers were quite telling.”

Although the study did not focus on what causes the misdiagnosis, Singh said that there could be many reasons why an outpatient is not receiving the proper care. Prior studies suggest that many breakdowns occur during the information gathering of an appointment, when a physician is taking a patient’s medical history and observing symptoms. Patients can reduce the risk of misdiagnosis by becoming more involved in their own care; including following up on medical tests and notifying their doctors if their symptoms get worse.

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