Diagnostic Error: The Hidden Epidemic, Case Study Example

Psychosomatic disorders are known as physical illnesses whose causes are in close relation with psychosocial elements and contain both organic and functional disorders (Graber & Carlson, 2011). The treatment of these diseases is primarily based on absolute differential diagnoses, inclusive of functional disorders. However, in some cases, illnesses whose cause is unknown are occasionally diagnosed as psychosomatic illnesses.

These issues have become quite rampant due to the increasing number of patients with psychosomatic illnesses. Reducing diagnostic errors is essential for the quality of life and ensuring the safety of patients (Norman & Eva, 2010). The aim of this research was to elaborate on the factors that affect misdiagnoses in psychosomatic medicine through the examination of typical cases and the exploration of strategies that facilitate the reduction of diagnostic errors.

Identification of Main Issue

The main issue in this case study is the misdiagnosis of diseases whose origins are unknown mostly as either “psychogenic” or “psychosomatic”. This is a problem especially when focusing on the safety of the patients and the quality of medical services they receive (Graber & Carlson, 2011). The causes of these diagnostic errors are identified as cognitive errors on the part of the Physician and a systemic error in hospitals. This research was aimed at elaborating on the factors that affect diagnostic errors with special attention given to through the analysis of typical cases and the exploration of strategies that facilitate the reduction of diagnostic errors.

Analysis of the Issue

Medical errors occur across the spectrum of medication delivery, from prescription to administration and follow-up. In the United States (U.S.), preventable medication errors affect more than two million hospital stays, prolonging the length of stay and costing an estimated $3.5 billion (Lahue et al., 2012). The investigation time frame was between January 2001 and August 2017. Researchers involved gathered the patients’ information from their visits to the Psychosomatic Medical Department at the hospital in Kindai University together with its backup centers. All patients were matured 16 years or over.

Different elements, for example, age, sex, introducing indications, introductory conclusion, last finding, wellsprings of re-analysis and sorts of analytic mistakes were reflectively investigated from the restorative graphs of a total of 20 patients to encourage the examination. Of the 20 cases, 4 runs of the mill cases are depicted as follows; the first Case involved a 79-year-elderly person who was at first determined to have psychogenic heaving because of melancholy but the diagnosis was changed to gastric torsion as the last conclusion. The second Case involved a 24-year-old who was determined to have a dietary issue initially but the diagnosis was adjusted to esophageal achalasia. Case 10 involved an elderly person of 60 years whose diagnosis was adjusted from transformation issue to limited muscle decay. Case 19 involved a person of 68 years, craving misfortune from melancholy because of malignant growth changed to auxiliary adrenal inadequacy, disengaged ACTH insufficiency (IAD).

Effective Solutions, Strategies, and Use of Tools

The co-creators assembled cases in which the last finding was essentially not the same as the underlying conclusion. Practically all cases, aside from cases 3 and 20, were alluded from another emergency clinic or another division in Kindai University Hospital or Sakai Hospital that announced their underlying conclusion. With respect to cases 3 and 20, both the underlying and last finding were made in our specialization. Every essential specialist in the contentions made an exact, conclusive analysis through efficient assessment, however at times; a heuristic strategy decided the ailments. Two specialists autonomously analyzed the procedure of analysis and made a decision about the kind of demonstrative blunder. In the wake of examining their discoveries, their accord on the sort of symptomatic blunder was embraced.

The examination introduced a few constraints. Initially, this investigation depended on meeting cases just in Kindai University Hospital or Sakai Hospital. Further examinations are expected to explain elements identified with the misdiagnosis of patients visiting divisions of psychosomatic prescription. Second, there was trouble in observing the particular components of misdiagnosis. Clinical thinking depended on numerous perspectives and it was incomprehensible that all clinicians in this investigation could review the definite circumstances and the reason for determination because of time overlay and contrasts in their clinical learning (Phua and Tan, 2013). Third, there was the unavoidable inclination of any review examination in which the result was known. In spite of the fact that the investigation had a few impediments, some exceptionally intriguing outcomes could be viewed as accommodating data for clinical psychosomatic practice and for recognizing themes for future examinations. So as to explain the reasons for indicative blunders and to improve methodologies to advance psychosomatic drug, further research tending to the present examination’s restrictions is important.

This examination demonstrated that few components associated with misdiagnoses were interwoven and had a typical impact. Nonetheless, it is possible to outline them into two significant clinical perceptions, analytic framework related issues, and supplier issues (Norman & Eva, 2010). Supplier issues contain predominantly subjective predispositions, for example, Availability, Anchoring, Confirmation inclination, Delayed determination, and Representativeness. So as to stay away from indicative mistakes, both a symptomatic framework approach together with the decrease of subjective predispositions is required. Psychosomatic drug specialists should give more consideration to physical indications and foundational assessment and can assume a significant job in tolerating a view of patients dependent on a decent, non-biased patient/doctor relationship.

References

Graber ML, Carlson B. Diagnostic error: the hidden epidemic. Physician Exec. 2011;37(6):12–4. 16, 18-9

Lahue, B.J., Pyenson, B., Iwasaki, K., Blumen, H.E., Forray, S., Rothschild, J.M. (2012). National burden of preventable adverse drug events associated with inpatient injectable medications: Healthcare and medical professional liability costs. American Health and Drug Benefits, 5(7),1– 10.

Norman GR, Eva KW. Diagnostic error and clinical reasoning. Med Educ. 2010;44(1):94–100. https://doi.org/10.1111/j.1365-2923.2009.03507.x.

Phua DH, Tan, NC. Cognitive aspect of diagnostic errors. Ann Acad Med Singap. 2013;42(1):33–41.