misdiagnose

Misdiagnosis refers to the incorrect identification of a patient’s medical condition. It occurs when the final diagnosis is wrong, leading to inappropriate treatment, unnecessary tests, or delayed care. Misdiagnosis can affect any field of medicine and can involve errors at any stage of the diagnostic process, from history-taking to interpretation of tests.

Misdiagnosis can be categorized as false positives, where a condition is diagnosed but is not present, and false negatives, where a condition is present but not recognized. Some errors involve mislabeling a condition as another, or missing a diagnosis altogether. In many cases, diagnostic error reflects a combination of factors rather than a single mistake.

Causes include cognitive biases such as premature closure and anchoring, incomplete or biased information, atypical or non-specific symptoms, limitations or misinterpretation of tests, and communication breakdowns among clinicians, patients, and laboratories. System factors such as time pressure, fragmented care, limited access to imaging or specialty consultation, and poor follow-up can also contribute.

Consequences range from unnecessary treatment and adverse drug effects to progression of an unmanaged illness and avoidable death. Misdiagnosis can erode trust in the healthcare system and has legal and ethical implications for clinicians and institutions. It also increases healthcare costs due to inappropriate care and repeated investigations.

Efforts to reduce misdiagnosis include encouraging second opinions, using structured differential diagnoses and diagnostic checklists, employing decision-support tools, and ensuring thorough follow-up and reconsideration of diagnoses when patients do not respond to treatment. Education, feedback on diagnostic performance, and system-level reforms to improve information sharing and access to care are also important.

Related topics include diagnostic error, differential diagnosis, and patient safety.