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Around 795,000 Americans die, are disabled each year from misdiagnoses

A report on deaths or permanent disabilities from misdiagnoses has proven "a public health crisis," according to researchers.
Around 795,000 Americans die, are disabled each year from misdiagnoses
Posted at 9:39 PM, Jul 18, 2023

An estimated 795,000 Americans die or become permanently disabled every year because of incorrect diagnoses, new analysis of national data found.

This statistic is the result of what's believed to be a first-of-its-kind national estimate report of diagnostic errors leading to permanent disability and death.

Medical researchers from the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence and from the Risk Management Foundation of the Harvard Medical Institutions conducted the analysis, first published by BMJ Quality & Safety on July 17.

They found a national estimate of 371,000 deaths and 424,000 permanent disabilities result from diagnostic errors across care settings, matching data from multiple other studies focusing on "diagnostic errors in ambulatory clinics and emergency departments during inpatient care."

Previous estimates of these errors were wide-ranging, estimating anywhere from 40,000 to 4 million per year, according to the report's lead investigator.

"Prior work has generally focused on errors occurring in a specific clinical setting, such as primary care, the emergency department or hospital-based care," said Dr. David Newman-Toker, director of the Center for Diagnostic Excellence. "The methods used in our study are notable because they leverage disease-specific error and harm rates to estimate an overall total."

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Researchers found 15 diseases account for 50.7% of these serious errors, but just five diseases account for 38.7% of misdiagnoses: Stroke, sepsis, pneumonia, venous thromboembolism and lung cancer.

Across diseases, the overall average error rate is 11.1%, with low-end misses being 1.5% for heart attacks, and, on the opposite end, 62% misses for spinal abscess. But the most common misdiagnosis causing serious harm is stroke, found to be missed in 17.5% of cases.

These diseases causing the most misdiagnosis-related harms should become top focuses for creating disease-specific solutions, the report says. Reducing stroke misses has already been a focus at Johns Hopkins, with solutions already being developed and deployed.

"A disease-focused approach to diagnostic error prevention and mitigation has the potential to significantly reduce these harms," Newman-Toker said. "Reducing diagnostic errors by 50% for stroke, sepsis, pneumonia, pulmonary embolism and lung cancer could cut permanent disabilities and deaths by 150,000 per year."

Though focusing on these certain diseases could cut many harms, funding for solutions remains an issue. Newman-Toker says it's the "most under-resourced public health crisis we face."

"If we are to achieve diagnostic excellence and the goal of zero preventable harm from diagnostic error, we must continue to invest in efforts to achieve success," he said.

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