UK: Wrong diagnoses are killing patients

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Sheri Nakken
Posts: 3999
Joined: Wed Apr 01, 2020 10:00 pm

UK: Wrong diagnoses are killing patients

Post by Sheri Nakken »

Love this logic....
" The
reason, experts say, is not incompetence but that so few post-mortems are
now performed that doctors cannot learn from their mistakes."

and how about this one?
""That's not to say doctors are not doing their jobs properly. It's just
that even
with all the high-tech equipment we have now, it's not always possible to
make the correct diagnosis."

"Another problem, Underwood says, is that some doctors are not keen to
encourage post-mortems for fear they might reveal that inappropriate
treatment had been given. "Some are frightened that families will sue.""

"
http://www.newscientist.com/news/news.jsp?id=ns99994693

Wrong diagnoses are killing patients

19:00 18 February 04

Many patients in intensive care units are being wrongly diagnosed, according
to a study in a UK hospital. Some are dying because doctors fail to spot
major conditions such as heart attacks, cancer and pulmonary embolism. The
reason, experts say, is not incompetence but that so few post-mortems are
now performed that doctors cannot learn from their mistakes.

Fang Gao Smith, a consultant in intensive care medicine at Birmingham
Heartlands Hospital, and her team checked the accuracy of diagnoses by
comparing post-mortem results with patients' medical records. In 39 per cent
of cases, they found major problems had been missed.

The problem is not limited to one hospital, or to the UK. Gao Smith says her
findings are consistent with other studies done in Europe and the US. She
thinks doctors place too much faith in sophisticated scanners when making
diagnoses, and are failing to learn from their mistakes because fewer and
fewer autopsies are being done, both in the UK and the US.

"If we did more post-mortems it might be possible to save more people in the
future," Gao Smith says. The decline needs to be reversed as a matter of
urgency, she says.

Other experts agree. "We have suspected that 30 per cent of diagnoses may
not be correct," says James Underwood, a pathologist at the University of
Sheffield and president of the UK's Royal College of Pathologists. "That's
not to say doctors are not doing their jobs properly. It's just that even
with all the high-tech equipment we have now, it's not always possible to
make the correct diagnosis."

The study also raises the question of how many other patients are being
misdiagnosed. Gao Smith says the frequent misdiagnoses in intensive care
units should set alarm bells ringing in other areas of medicine.

"It's not always possible to talk to intensive care patients. But they are
also scrutinised and monitored more than any other patients, so I'm not sure
we can say that they are more likely to suffer misdiagnosis."

Gao Smith's study covered a three-year period. During this time, of 2213
patients treated in the Heartlands Hospital intensive care unit, 636 died.
Just 49 post-mortems were done, and the results of 38 were available to the
team. Of these, only 17 diagnoses turned out to be completely correct. In
15, major conditions had been missed, including three undiagnosed heart
attacks. In 10 of these cases, patients might have survived if the diagnosis
had been more accurate. Others suffered unnecessarily because of
inappropriate treatment.

In the UK, hospital post-mortems can only be done with the permission of the
deceased's family unless there are suspicious circumstances. Since 1991, the
proportion of deaths in UK hospitals followed up by a post-mortem has fallen
from one in 10 to around one in 40 (see graphic). The decline has
accelerated in the past five years, following a scandal over body parts
being retained without families' permission at Alder Hey Children's Hospital
in Liverpool.

Doctors in the US are also worried about the decline in autopsies. In 1995,
the National Center for Health Statistics stopped collecting autopsy
statistics, so authorities in the US do not even know if the decline is
continuing.

Another problem, Underwood says, is that some doctors are not keen to
encourage post-mortems for fear they might reveal that inappropriate
treatment had been given. "Some are frightened that families will sue."

Journal reference: Critical Care (vol 7, issue 6)
Michael Day

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