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Diagnostic errors in three medical eras: a necropsy study.

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Title: Diagnostic errors in three medical eras: a necropsy study.
Authors: Sonderegger-Iseli, Katharina, Burger, Stefanie, Muntwyler, Jorg, Sonderegger-Iseli, K (AUTHOR), Burger, S (AUTHOR), Muntwyler, J (AUTHOR), Salomon, F (AUTHOR)
Source: Lancet. 6/10/2000, Vol. 355 Issue 9220, p2027-2031. 5p. 1 Diagram, 4 Charts, 1 Graph.
Subjects: Diagnostic errors, Medical errors, Diagnosis, Clinical medicine
Abstract: Background: Studies comparing the accuracy of clinical diagnosis in unselected patients who died in hospital in different medical eras have shown no decline of errors in the main diagnosis. We assessed changes in diagnostic accuracy over 20 years.Methods: We analysed retrospectively diagnostic errors, with use of necropsy as the gold standard for diagnosis. We randomly selected 300 patients who died at a tertiary-care teaching hospital in Switzerland--100 in each of 1972, 1982, and 1992. We classified discrepancies between clinical diagnosis and necropsy findings as major and minor errors.Findings: The overall necropsy rate at the hospital stayed at around 90% for the whole period. During the study, the frequency of major discrepancies declined significantly (1972, 30%; 1982, 18%; 1992, 14%; p=0.007). The rate of minor diagnostic errors increased significantly from 23% in 1972 to 46% in 1992 (p<0.001). The increase in overall diagnostic accuracy occurred mainly because of a significant improvement in specificity for cardiovascular diseases (1972, 85%; 1982, 82%; 1992, 97%; p=0.034) and non-significantly improved sensitivity (1972, 69%; 1982, 82%; 1992, 86%; p=0.061). Sensitivity also improved for infectious diseases (1972, 25%; 1982, 67%; 1992, 86%; p=0.036). Sensitivity and specificity for neoplastic diseases were high originally and did not change. The total number of diagnostic procedures per year increased from 191 in 1972 to 259 in 1992, mainly because of non-invasive techniques, such as ultrasonography, and endoscopies.Interpretation: The frequency of major diagnostic errors in unselected patients who died in hospital was halved over 20 years, probably because of improved clinical skills and new diagnostic procedures. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Diagnostic errors in three medical eras: a necropsy study.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sonderegger-Iseli%2C+Katharina%22&quot;&gt;Sonderegger-Iseli, Katharina&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Burger%2C+Stefanie%22&quot;&gt;Burger, Stefanie&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Muntwyler%2C+Jorg%22&quot;&gt;Muntwyler, Jorg&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sonderegger-Iseli%2C+K%22&quot;&gt;Sonderegger-Iseli, K&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Burger%2C+S%22&quot;&gt;Burger, S&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Muntwyler%2C+J%22&quot;&gt;Muntwyler, J&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Salomon%2C+F%22&quot;&gt;Salomon, F&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Lancet%22&quot;&gt;Lancet&lt;/searchLink&gt;. 6/10/2000, Vol. 355 Issue 9220, p2027-2031. 5p. 1 Diagram, 4 Charts, 1 Graph.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Diagnostic+errors%22&quot;&gt;Diagnostic errors&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+errors%22&quot;&gt;Medical errors&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Diagnosis%22&quot;&gt;Diagnosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Clinical+medicine%22&quot;&gt;Clinical medicine&lt;/searchLink&gt;
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  Data: &lt;bold&gt;Background: &lt;/bold&gt;Studies comparing the accuracy of clinical diagnosis in unselected patients who died in hospital in different medical eras have shown no decline of errors in the main diagnosis. We assessed changes in diagnostic accuracy over 20 years.&lt;bold&gt;Methods: &lt;/bold&gt;We analysed retrospectively diagnostic errors, with use of necropsy as the gold standard for diagnosis. We randomly selected 300 patients who died at a tertiary-care teaching hospital in Switzerland--100 in each of 1972, 1982, and 1992. We classified discrepancies between clinical diagnosis and necropsy findings as major and minor errors.&lt;bold&gt;Findings: &lt;/bold&gt;The overall necropsy rate at the hospital stayed at around 90% for the whole period. During the study, the frequency of major discrepancies declined significantly (1972, 30%; 1982, 18%; 1992, 14%; p=0.007). The rate of minor diagnostic errors increased significantly from 23% in 1972 to 46% in 1992 (p&lt;0.001). The increase in overall diagnostic accuracy occurred mainly because of a significant improvement in specificity for cardiovascular diseases (1972, 85%; 1982, 82%; 1992, 97%; p=0.034) and non-significantly improved sensitivity (1972, 69%; 1982, 82%; 1992, 86%; p=0.061). Sensitivity also improved for infectious diseases (1972, 25%; 1982, 67%; 1992, 86%; p=0.036). Sensitivity and specificity for neoplastic diseases were high originally and did not change. The total number of diagnostic procedures per year increased from 191 in 1972 to 259 in 1992, mainly because of non-invasive techniques, such as ultrasonography, and endoscopies.&lt;bold&gt;Interpretation: &lt;/bold&gt;The frequency of major diagnostic errors in unselected patients who died in hospital was halved over 20 years, probably because of improved clinical skills and new diagnostic procedures. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1016/S0140-6736(00)02349-7
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      – Code: eng
        Text: English
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        PageCount: 5
        StartPage: 2027
    Subjects:
      – SubjectFull: Diagnostic errors
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      – SubjectFull: Medical errors
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      – SubjectFull: Diagnosis
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      – SubjectFull: Clinical medicine
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      – TitleFull: Diagnostic errors in three medical eras: a necropsy study.
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            NameFull: Sonderegger-Iseli, Katharina
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              Text: 6/10/2000
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              Y: 2000
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