Prevalence of Diagnostic Errors in the ICU Assessed
(HealthDay News) – Diagnostic errors in the intensive care unit (ICU) are prevalent, with 28% of autopsies reporting at least one misdiagnosis, according to a study published online July 21 in BMJ Quality & Safety.
Bradford Winters, MD, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues reviewed the literature for observational studies examining autopsy-confirmed diagnostic errors in the adult ICU. A total of 31 studies describing 5,863 autopsies were included.
The researchers found that the prevalence of misdiagnoses ranged from 5.5%–100%. At least one misdiagnosis was reported by 28% of autopsies, and 8% identified a Class I diagnostic error. For a hypothetical autopsy rate of 100%, the projected prevalence of Class I misdiagnoses was 6.3%. The leading lethal misdiagnoses were vascular events and infections (41% each). Pulmonary embolism, myocardial infarction, pneumonia, and aspergillosis were the most common individual Class I misdiagnoses.
"In conclusion, this systematic review and analysis suggests that between 22,600–40,500 ICU patients die each year in the United States with, and potentially from, a diagnostic error and many more suffer a clinically relevant diagnostic error," the authors write. "To this point, diagnostic errors have received relatively little attention and research funding, leaving the methods to measure them immature; this must change."
One author provides expert testimony for several defense and plaintiff law firms.