TY - JOUR
T1 - Errors in Diagnosing Infectious Diseases
T2 - A Physician Survey
AU - Haddad, Mahboubeh
AU - Sheybani, Fereshte
AU - Naderi, Hamid Reza
AU - Sasan, Mohammad Saeed
AU - Najaf Najafi, Mona
AU - Sedighi, Malihe
AU - Seddigh, Atena
N1 - Funding Information: We acknowledge supports from the vice-chancellery for research of Mashhad University of Medical Sciences (Research Project Number 960433 and ethic code IR.MUMS.fm.REC.1396.413) as well as the clinical research and development unit of Imam Reza hospital are highly appreciated. We also thank all the physicians that answered our questionnaires with much patience. Publisher Copyright: Copyright © 2021 Haddad, Sheybani, Naderi, Sasan, Najaf Najafi, Sedighi and Seddigh.
PY - 2021/11/17
Y1 - 2021/11/17
N2 - Background: Infectious diseases are commonly missed or misdiagnosed. Errors in diagnosing infectious diseases not only affect the patient but also the community health. Objectives: To describe our investigation on the most common errors in diagnosing infectious diseases and their causes according to the physicians' reports. Methods: Between August 2018 and February 2019, specialist physicians and residents across Mashhad, Iran were invited to participate in a survey to report errors they had made or witnessed regarding the diagnosis of infectious diseases. Results: Overall, 465 cases were reported by 315 participants. The most common infectious diseases affected by diagnostic errors were upper respiratory tract infections (URTIs) (n = 69, 14.8%), tuberculosis (TB) (n = 66, 14.1%), pleuro-pulmonary infections (n = 54, 11.6%), central nervous system (CNS) infections (n = 51, 10.9%), and urinary tract infections (n = 45, 9.6%). Errors occurred most frequently in generating a diagnostic hypothesis (n = 259, 55/7%), followed by history taking (n = 200, 43%), and physical examination (n = 191, 41/1%). Errors related to the diagnosis of TB (odds ratio [OR]: 2.4, 95% confidence interval [CI]:0.9–5.7; P value: 0.047) and intra-abdominal infections (OR: 7.2, 95% CI: 0.9–53.8; P value: 0.02) were associated with more-serious outcomes. Conclusion: A substantial proportion of errors in diagnosing infectious diseases moderately or seriously affect patients' outcomes. URTIs, TB, and pleuropulmonary infections were the most frequently reported infectious diseases involved in diagnostic error while errors related to the diagnosis of TB and intraabdominal infections were more frequently associated with poor outcomes. Therefore, contagious and potentially life-threatening infectious diseases should always be considered in the differential diagnosis of patients who present with compatible clinical syndromes.
AB - Background: Infectious diseases are commonly missed or misdiagnosed. Errors in diagnosing infectious diseases not only affect the patient but also the community health. Objectives: To describe our investigation on the most common errors in diagnosing infectious diseases and their causes according to the physicians' reports. Methods: Between August 2018 and February 2019, specialist physicians and residents across Mashhad, Iran were invited to participate in a survey to report errors they had made or witnessed regarding the diagnosis of infectious diseases. Results: Overall, 465 cases were reported by 315 participants. The most common infectious diseases affected by diagnostic errors were upper respiratory tract infections (URTIs) (n = 69, 14.8%), tuberculosis (TB) (n = 66, 14.1%), pleuro-pulmonary infections (n = 54, 11.6%), central nervous system (CNS) infections (n = 51, 10.9%), and urinary tract infections (n = 45, 9.6%). Errors occurred most frequently in generating a diagnostic hypothesis (n = 259, 55/7%), followed by history taking (n = 200, 43%), and physical examination (n = 191, 41/1%). Errors related to the diagnosis of TB (odds ratio [OR]: 2.4, 95% confidence interval [CI]:0.9–5.7; P value: 0.047) and intra-abdominal infections (OR: 7.2, 95% CI: 0.9–53.8; P value: 0.02) were associated with more-serious outcomes. Conclusion: A substantial proportion of errors in diagnosing infectious diseases moderately or seriously affect patients' outcomes. URTIs, TB, and pleuropulmonary infections were the most frequently reported infectious diseases involved in diagnostic error while errors related to the diagnosis of TB and intraabdominal infections were more frequently associated with poor outcomes. Therefore, contagious and potentially life-threatening infectious diseases should always be considered in the differential diagnosis of patients who present with compatible clinical syndromes.
KW - cognitive biases
KW - diagnostic errors
KW - infectious diseases
KW - patient safety
KW - survey
UR - http://www.scopus.com/inward/record.url?scp=85120729328&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fmed.2021.779454
DO - https://doi.org/10.3389/fmed.2021.779454
M3 - Article
C2 - 34869499
SN - 2296-858X
VL - 8
JO - Frontiers in Medicine
JF - Frontiers in Medicine
M1 - 779454
ER -