[EXTERNAL] [IMPROVEDX] quick ?

Peggy Zuckerman peggyzuckerman at GMAIL.COM
Thu Apr 24 19:27:19 UTC 2014


This discussion fails to address a big component, that of delayed
diagnosis, which delayed treatments, etc.  Delayed diagnosis is most likely
unmeasureable and thereby cannot exist statistically.  We must never
underestimate how this issue adds to and distorts the general statistics
surrounding any disease.

Daily, I read of late diagnosis of cancers that present early on in the
patient's life, the symptoms of which are ignored or dismissed for mulitple
reasons.  These are eventually diagnosed (we assume), at which time the
cancer is at a Stage IV, with fewer options, etc.

We women of a certain age are often reassured that any new symptom we
report is attributable to menopause or age, even those which are supported
by lab tests that in a male would likely be thought more worthy of further
review.  Wish I were wrong on this.

Peggy Z


On Thu, Apr 24, 2014 at 11:57 AM, robert bell <rmsbell at esedona.net> wrote:

> Is that for all radiological evaluations, CT, MRI, standard Xray, hard
> tissue, soft tissue, breasts, etc., etc?
>
> Seems low to me.
>
> Rob Bell
>
>
>
>
>
> On Apr 23, 2014, at 12:00 PM, Leonard Berlin <lberlin at LIVE.COM> wrote:
>
> There are reliable data in the radiologic literature that indicate that
> the average error rate among radiologists' interpretation of radiographic
> exams is approximately 3%.  Fortunately, most of these errors are
> inconsequential clinically.
>
> Lenny
>
> Leonard Berlin, MD, FACR
> Radiology Department, Skokie Hospital
> Skokie, IL;
> Professor of Radiology
> Rush University, and
> University of Illinois
> Chicago, IL
>
>
>
> > Date: Wed, 23 Apr 2014 13:32:12 -0400
> > From: Mark.Graber at VA.GOV
> > Subject: Re: [IMPROVEDX] [EXTERNAL] [IMPROVEDX] quick ?
> > To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> >
> > Stephen,
> >
> > We (I) believe the risk of diagnostic error in general medical settings
> in the US is in the range of 10 - 15% (Graber. The Incidence of Diagnostic
> Error in Medicine; BMJ Qual Saf 2013;22:ii21-ii27.
> doi:10.1136/bmjqs-2012-001615). That's all errors, most of which
> (thankfully) are inconsequential or caught. The risk of harm is clearly
> much less and its hard to put a number on that.
> >
> > The news stories centered on Hardeep's recent article ( The frequency of
> diagnostic errors in outpatient care: estimations from three large
> observational studies
> > involving US adult populations. Singh H, et al. BMJ Qual Saf 2014;0:1-5.
> doi:10.1136/bmjqs-2013-002627) where they identified a risk of
> approximately 5% from chart reviews in primary care clinics. That number is
> in the 10-15% ballpark, given that the approach would have missed errors
> that weren't obvious from the medical record, and errors for which the
> consequences played out elsewhere, and other methodologic issues.
> >
> > All of these numbers are based on research approaches. So far, there
> aren't any healthcare organizations I know of that are measuring error
> rates in real time, and the challenges of actually doing this are
> substantial. We have little data on the error rate for surgical patients,
> or patients seen in the ER. There is a great need for research on this
> question, and for finding reliable and reproducible ways to find and count
> these errors going forward. You can't improve what you can't measure.
> >
> > Mark
> >
> > Mark L Graber, MD FACP
> > Senior Fellow, RTI International
> > Professor Emeritus, SUNY Stony Brook School of Medicine
> > Founder and President, Society to Improve Diagnosis in Medicine
> > Phone: 919 990-8497
> >
> >
> > ________________________________
> > From: "Pauker, Stephen" <SPauker at TUFTSMEDICALCENTER.ORG>
> > Reply-To: Society to Improve Diagnosis in Medicine <
> IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, "Pauker, Stephen" <
> SPauker at TUFTSMEDICALCENTER.ORG>
> > Date: Wed, 23 Apr 2014 12:01:55 -0400
> > To: <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
> > Subject: [EXTERNAL] [IMPROVEDX] quick ?
> >
> > What # is quoted for freq of diag errors in routine practice
> > without reference to selection bias??
> >
> > I think I heard a news story quoting something like 40% of encounters or
> patients.
> > Hard to believe that # which seems grossly inflated
> >
> > Steve
> > The information in this e-mail is intended only for the person to whom
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> Moderator: Lorri Zipperer Lorri at ZPM1.com, Communication co-chair, Society
> for Improving Diagnosis in Medicine
>
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> for Improving Diagnosis in Medicine
>
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-- 
Peggy Zuckerman
www.peggyRCC.wordpress.com







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