onderdiagnose

Underdiagnose, or underdiagnosis, refers to the situation in which a person who has a disease or condition remains undetected by health care providers. In practice, underdiagnosis results in delayed or absent treatment and may distort estimates of disease burden. It is distinct from misdiagnosis, where a condition is incorrectly identified, and from undertreatment, where a diagnosed condition is not adequately treated.

Causes include patient-related factors such as limited access to care, stigma, or inability to report symptoms; provider-related factors such as cognitive biases, time constraints, and reliance on atypical presentations; and system-related factors such as inadequate screening, limited resources, or outdated guidelines. Certain populations are at higher risk, including older adults with mental health conditions, women with autism spectrum disorder, and people in low-resource settings.

Consequences include progression of disease, poorer outcomes, decreased quality of life, higher morbidity and mortality, and inaccurate public health estimates that can hinder resource allocation and prevention planning.

Strategies to reduce underdiagnosis encompass routine, guideline-based screening; risk-based assessment; improved access to care; decision-support tools and clinical training; culturally competent communication; and public health surveillance that uses multiple data sources to identify suspected gaps.

In Dutch-language health literature, onderdiagnose is the term used for underdiagnosis.