The effective treatment of disease begins with an accurate diagnosis. The failure to diagnose an illness properly can lead to extended sickness and unnecessary medical complications.
Many factors come into play when correctly diagnosing a disease: an accurate assessment of symptoms, the doctor's knowledge of the condition, effective laboratory testing and the patient's ability to communicate symptoms.
Because identifying an illness is a complex process, misdiagnosis is one of the more common medical mistakes. Misdiagnosis can take several forms, from the failure to diagnose an illness to a partial diagnosis. A partial diagnosis may misidentify the correct subtype of disease, miss medication causes, related conditions or certain complications associated with the disease. The failure to diagnose means misidentifying the disease entirely.
Misdiagnosis follows certain patterns: some diseases are more difficult to diagnose than others, while some medical settings lead to misdiagnosis more frequently than others.
Infant conditions; mental, emotional and behavioral disorders; digestive diseases; rare conditions; and illnesses with vague symptoms can all be challenging to assess accurately.
o Infant conditions: Because infants can not communicate verbally, diagnosing an illness is naturally more challenging. Doctors must be especially attuned to behavioral signals, such as eye-rubbing or ear-pulling as possible clues to identifying illness. A thorough physical exam and lab tests also hold significant importance when assessing infants.
o Mental, emotional and behavioral disorders: The motivations and causes of human behavior range widely from one individual to another, making the correct diagnosis of these disorders difficult. In many cases, patients may not be aware of changes in their behavior or be able to accurately communicate changes in their moods or mental states. Plus, physical tests, such as urine or blood tests, may not be useful in diagnosing the disorder.
o Digestive diseases: Accurately diagnosing these illnesses present a challenge because of their similarity. Different digestive diseases can share similar symptoms, which can complicate pinpointing the exact disease.
o Illnesses with vague symptoms: Symptoms provide the clues a doctor uses to determine the type and cause of an illness. When symptoms are vague, fleeting or variable, identifying the underlying disease is difficult. For example, many conditions are associated with general fatigue, such as lupus, multiple sclerosis, chronic fatigue syndrome, Lyme disease and hypothyroidism.
o Rare conditions: Diagnosing an illness depends , in part, on recognizing patterns and making correlations between symptoms. Rare conditions can defy easy classification because they may not fit familiar disease patterns. Or they may fit familiar disease patterns and be mistaken for a more common disease. Plus, if a doctor has never encountered a rare disease before, the chances of diagnosing it correctly are lower.
Where a patient is diagnosed also can affect the accuracy of the assessment. Emergency rooms are likely to have a higher rate of the failure to diagnose a condition properly. The time and environmental pressure involved in diagnosing patients in an ER help account for the greater incidence of misdiagnosis in this setting.
A large portion of malpractice cases result from the failure to diagnose patients properly. Among the top misdiagnosed conditions leading to malpractice lawsuits are breast cancer, myocardial infarction, lung cancer and colon cancer.
The failure to diagnose a disease delays proper treatment and increases the probability of the disease causing harm. Seeking a second opinion is one of the best methods of ensuring proper diagnosis. Multiple opinions can be invaluable, especially when it comes to diseases that are inherently hard to diagnose.