Fehldiagnose

Fehldiagnose refers to a diagnostic error in which the clinician's final diagnosis does not correctly identify the patient's condition, or a condition is not recognized when it is present. It encompasses false-positive findings, false-negative findings, and delayed diagnoses, as well as misclassification of related conditions.

Causes include cognitive biases such as premature closure and anchoring, incomplete or misleading information, atypical symptom presentations, limited access to diagnostic tests, communication failures, and systemic factors like time pressure, fragmentation of care, and lack of follow-up.

It occurs across medical specialties and patient populations. Common contexts include cardiology, oncology, infectious disease, neurology, pediatrics, and mental health. Diagnostic errors can arise from rare diseases or unusual manifestations of common diseases, as well as from comorbidities that mask typical signs.

Consequences include harm to patients due to inappropriate treatment or treatment delays, unnecessary testing and procedures, increased costs, psychological distress, and legal risk for clinicians. Diagnostic errors are a major focus of patient safety research and quality improvement initiatives.

Prevention and mitigation strategies emphasize structured diagnostic reasoning and information gathering, second opinions, diagnostic checklists, routine follow-up and red-flag protocols, clinical decision support tools, and improvements in care coordination and communication among providers and with patients.