Errors in Diagnosing Infectious Diseases: A Physician Survey

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...

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Main Authors: Mahboubeh Haddad, Fereshte Sheybani, HamidReza Naderi, Mohammad Saeed Sasan, Mona Najaf Najafi, Malihe Sedighi, Atena Seddigh
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-11-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2021.779454/full
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author Mahboubeh Haddad
Fereshte Sheybani
HamidReza Naderi
Mohammad Saeed Sasan
Mona Najaf Najafi
Malihe Sedighi
Atena Seddigh
author_facet Mahboubeh Haddad
Fereshte Sheybani
HamidReza Naderi
Mohammad Saeed Sasan
Mona Najaf Najafi
Malihe Sedighi
Atena Seddigh
author_sort Mahboubeh Haddad
collection DOAJ
description 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.
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spelling doaj.art-122dc840dc8340bd8674bae17d7b6e762022-12-22T04:03:55ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-11-01810.3389/fmed.2021.779454779454Errors in Diagnosing Infectious Diseases: A Physician SurveyMahboubeh Haddad0Fereshte Sheybani1HamidReza Naderi2Mohammad Saeed Sasan3Mona Najaf Najafi4Malihe Sedighi5Atena Seddigh6Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranClinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranFaculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranFaculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranBackground: 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.https://www.frontiersin.org/articles/10.3389/fmed.2021.779454/fullinfectious diseasesdiagnostic errorscognitive biasespatient safetysurvey
spellingShingle Mahboubeh Haddad
Fereshte Sheybani
HamidReza Naderi
Mohammad Saeed Sasan
Mona Najaf Najafi
Malihe Sedighi
Atena Seddigh
Errors in Diagnosing Infectious Diseases: A Physician Survey
Frontiers in Medicine
infectious diseases
diagnostic errors
cognitive biases
patient safety
survey
title Errors in Diagnosing Infectious Diseases: A Physician Survey
title_full Errors in Diagnosing Infectious Diseases: A Physician Survey
title_fullStr Errors in Diagnosing Infectious Diseases: A Physician Survey
title_full_unstemmed Errors in Diagnosing Infectious Diseases: A Physician Survey
title_short Errors in Diagnosing Infectious Diseases: A Physician Survey
title_sort errors in diagnosing infectious diseases a physician survey
topic infectious diseases
diagnostic errors
cognitive biases
patient safety
survey
url https://www.frontiersin.org/articles/10.3389/fmed.2021.779454/full
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