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Literature review of medical errors and misdiagnosis

None, Conflict of Interest: The persistent problem of diagnostic errors. Ann Nigerian Med 2016;10: To err is human: Building a safer health system.

The report brought patients' safety issues to medical and public attention and highlighted the gross under-reporting of medical errors, especially diagnostic errors. The truth though is that the study of medical diagnostic errors is a most challenging feat as it is very difficult to detect and analyze. In a 2013 report by Graber, various research approaches to determining the incidence of medical errors were enumerated. These include autopsy reviews, literature review of medical errors and misdiagnosis patients, second reviews, diagnostic testing audits, patient and provider surveys, malpractice claims, case reviews, and voluntary reports.

Certain studies on malpractice claims have revealed that diagnosis errors far outnumber medication errors as a cause of lodged claims.


Autopsy reviews have found the rates of major missed diagnosis to be rather wide with values of 4. Diagnosis errors are not only the most common medical errors, but they also represent the most dangerous of medical mistakes. As far as testing-related diagnostic errors are concerned, Epner et al. An inappropriate test is ordered An appropriate test is not ordered An appropriate test result is misapplied An appropriate test is ordered but a delay occurs somewhere in the testing process and lastly The report of an appropriately ordered test is inaccurate.

Herein lies the crux of the problem: If these errors are not reported and the appropriate steps are not taken to forestall future occurrences, it creates a huge pile of misdiagnosis or missed diagnosis that is inevitably swept under the carpet leaving the patient literature review of medical errors and misdiagnosis bear the brunt of these errors.

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It casts serious doubts on our purported morbidity and mortality statistics and raises serious questions about literature review of medical errors and misdiagnosis quality of especially tertiary medical care that we offer our teeming patients. In this regard, the sad decline of the hospital autopsy is unfortunate as its audit role is well documented.

In curbing these trends, a holistic approach to the problem is required. It is important that clear operational definitions of diagnostic errors are made by relevant regulatory bodies. Furthermore, certain questions need to be answered: Is literature review of medical errors and misdiagnosis possible for a diagnosis to be wrong without a diagnostic error?

What should be done when a diagnostic error is reported or inadvertently discovered? In addition, measures must be taken to improve clinical autopsy rates so that a veritable audit tool is not lost. There should be standardized protocols for reporting and reading radiological and laboratory investigations. Moreover, the cognitive reasoning must be deliberately captured in the curricula for undergraduate and postgraduate medical trainings.

In a collaborative team, individual roles must be well defined, and the team dynamics need to be clearly spelled out. There should also be practical strategies to monitor performance and measure incidence of errors when they occur.