Population Health

Misdiagnoses Linked to 370k Deaths Annually


A new study in The BMJ attracted a lot of attention last week after finding that the full impact of misdiagnoses in the U.S. is likely being seriously underestimated by the medical community.

The researchers estimate that 371k people die every year following a misdiagnosis, and 424k are permanently disabled – meaning nearly 800k people suffer “serious harm” annually. 

The lead author of the paper, Johns Hopkins Center for Diagnostic Excellence Director David Newman-Toker, said that “the number of diagnostic errors that happen out there in the U.S. each year is probably somewhere on the order of magnitude of 50 to 100 million.”

  • While these misdiagnoses don’t usually result in serious harm (most people aren’t seeing a doctor for a life-threatening condition), the study found that just 15 diseases account for about half of all misdiagnoses. 

Five diseases on their own – stroke, sepsis, pneumonia, venous thromboembolism, and lung cancer – caused almost 40% of the total “serious harm” incidents due to misdiagnosis.

  • That equates to 150k prevented deaths or disabilities every year if misdiagnoses could be cut in half for just those conditions.

The authors’ solution? Take a cue from the heart attack model. Although heart attacks frequently involve vague symptoms like general chest pain, they have less than a 2% chance of being misdiagnosed (vs. 18% for stroke). 

  • The study attributes that success to a decade of concentrated efforts, which started with recognizing that misdiagnosis was a problem and culminated with heavy research investments, new guidelines, and tighter requirements around performance monitoring.
  • “You end up ultimately with a system of care that focuses on not missing heart attacks. It’s the model for what we could be doing.”

The Takeaway

Although 800k annual incidents is an alarming total, the study concludes on the optimistic note that there’s still less than a 0.1% chance of serious harm related to misdiagnosis after a healthcare visit. That said, there’s clearly more to be done around improving the diagnosis of diseases that have severe consequences when missed, and this research does a good job highlighting the areas that should be a priority.

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