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Reliable methods for determining causes of misdiagnosis lacking
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Clinical experts may agree on what constitutes “serious misdiagnosis” under idealized conditions, but a reliable method for categorizing the root cause of the errors is lacking, according to a retrospective analysis.
C.E. Margo at the Watson Clinic in Lakeland, Fla., reported on a study in which three ocular oncology experts analyzed five cases retrospectively to evaluate the applicability and reliability of three classification systems for misdiagnosis. The main outcome measure was the percentage of agreement about the cause of the misdiagnosis.
In all the cases presented, the participants agreed that a misdiagnosis occurred. The error was graded as “serious” 14 of 15 times. However, inter-rater agreement about the cause of the error varied among the different classification systems by as much as 47%.
The root causes of misdiagnoses are complex, “often multifactorial and more difficult to categorize than other types of medical error,” the report in Quality & Safety in Health Care noted.