Diagnostic error in an ophthalmic emergency department
-
Harry Yip
,
Carmel Crock
Abstract
Background
Diagnostic error is a major preventable cause of harm to patients. There is currently limited data in the literature on the rates of misdiagnosis of doctors working in an ophthalmic emergency department (ED). Misdiagnosis was defined as a presumed diagnosis being proven incorrect upon further investigation or review.
Methods
In this retrospective audit, data was collected and analysed from 1 week of presentations at the Royal Victorian Eye and Ear Hospital (RVEEH) ED.
Results
There were 534 ophthalmic presentations during the study period. The misdiagnosis rates of referrers were: general practitioners (30%), optometrists (25.5%), external hospital EDs (18.8%), external hospital ophthalmology departments (25%) and private ophthalmologists (0%). Misdiagnosis rates of RVEEH doctors were: emergency registrars (7.1%), RVEEH residents (16.7%), first-year registrars (5.1%), second-year registrars (7.1%), third-year registrars (7.7%), fourth-year registrars (0%), senior registrars (6.9%), fellows (0%) and consultants (8.3%).
Conclusions
The misdiagnosis rates in our study were comparable to general medical diagnostic error rates of 10–15%. This study acts as a novel pilot; in the future, a larger-scale multi-centre audit of ophthalmic presentations to general emergency departments should be undertaken to further investigate diagnostic error.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Graber ML. The incidence of diagnostic error in medicine. BMJ Qual Saf 2013;22(Suppl 2):ii21–7.10.1136/bmjqs-2012-001615Suche in Google Scholar PubMed PubMed Central
2. Berner ES, Graber ML. Overconfidence as a cause of diagnostic error in medicine. Am J Med 2008;121(5 Suppl):S2–23.10.1016/j.amjmed.2008.01.001Suche in Google Scholar PubMed
3. Statham MO, Sharma A, Pane AR. Misdiagnosis of acute eye diseases by primary health care providers: incidence and implications. Med J Aust 2008;189:402–4.10.5694/j.1326-5377.2008.tb02091.xSuche in Google Scholar PubMed
©2020 Walter de Gruyter GmbH, Berlin/Boston
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Artikel in diesem Heft
- Frontmatter
- Editorials
- The novel coronavirus (2019-nCoV) outbreak: think the unthinkable and be prepared to face the challenge
- COVID Blindness
- Opinion Paper
- Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019 (COVID-19)
- Original Articles
- Clinical features, laboratory characteristics, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19): Early report from the United States
- Patient perceptions of misdiagnosis of endometriosis: results from an online national survey
- A survey of outpatient Internal Medicine clinician perceptions of diagnostic error
- Thresholds, rules and defensive strategies: how physicians learn from their prior diagnosis-related experiences
- Updates to referring clinicians regarding critically ill children admitted to the pediatric intensive care unit: a state-wide survey
- Diagnostic error in an ophthalmic emergency department
- Evaluation of the usefulness of the simultaneous assay of fecal hemoglobin (Hb) and transferrin (Tf) in colorectal cancer screening – for the establishment of the Hb and Tf two-step cutoff assay (HTTC assay)
- Case Report
- Factitious thyrotoxicosis: how to find it
- Letters to the Editors
- Letter to the Editor re Olson et al. “Competencies for improving diagnosis: an interprofessional framework for education and training in healthcare”
- Molecular diagnostics at the times of SARS-CoV-2 outbreak
