Wrong diagnoses common in doc’s office
‘Major public health problem’
WASHINGTON, Feb 26, (RTRS): Missed or wrong diagnoses are common in primary care and may put some patients at risk of serious complications, according to a U.S. study.
Mistakes in surgery and medication prescribing have been at the center of patient safety efforts, but researchers whose findings appeared in JAMA Internal Medicine said less attention has been paid to missed diagnoses in the doctor’s office.
Because of how common they are, those errors may lead to more patient injuries and deaths than other mistakes, according to David Newman-Toker from Johns Hopkins University School of Medicine in Baltimore, who co-wrote a commentary on the study.
“We have every reason to believe that diagnostic errors are a major, major public health problem,” Newman-Toker told Reuters Health. “You’re really talking about at least 150,000 people per year, deaths or disabilities that are resulting from this problem.”
For the study, researchers used electronic health records to track 190 diagnostic errors made during primary care visits at one of two healthcare facilities. In each of those cases, the misdiagnosed patient was hospitalized or turned up back at the office or emergency room within two weeks.
The study team found the type of missed diagnosis varied widely. Pneumonia, heart failure, kidney failure and cancer each accounted for between five and seven percent of conditions doctors initially diagnosed as something else. moving to 800 after age 70, according to the Institute of Medicine, which set those levels in 2010. The nutrients can come from various foods, including orange juice fortified with calcium and D; dairy foods such as milk, yogurt and cheese; certain fish including salmon; and fortified breakfast cereals. Harder to measure is how much vitamin D the body also produces from sunshine.
Most people should get enough calcium from food, said Mayo’s Khosla. But while he cautions against too high doses, he frequently tells his patients to take a multivitamin because it’s harder to get vitamin D from food and during the winter.
While supplement science gets sorted out, the task force’s Moyer advises healthy seniors to exercise — proven to shore up bones and good for the rest of the body, too.
Also: OTTAWA: Volunteer work has long been touted as good for the soul, but the practice is also good for your heart, according to a study out Monday in the journal to approve, aims simply to save those lives, Borg said, adding that the legislation needed to be brought up to date as the
Most diagnostic errors could have caused moderate or severe harm to the patient, the researchers determined. Of the 190 patients with diagnostic errors, 36 had serious permanent damage and 27 died.
One of the difficulties in making an accurate diagnosis is that certain common symptoms, such as stomach ache or shortness of breath, could be signs of a range of illnesses, both serious and not, researchers said.
“If you look at the types of chief complaints that these things occur with, they’re fairly common chief complaints,” said Hardeep Singh, who led the study at the Houston VA Health Services Research and Development Center of Excellence.
“If somebody would come in with mild shortness of breath and a little bit of cough, people would think you might have bronchitis, you might have phlegm... and lo and behold they would come back two days later with heart failure,” he told Reuters Health.
Most of the missed diagnoses were traced back to the office visit and the doctor not getting an accurate patient history, doing a full exam or ordering the correct tests.
One thing patients can do, the researchers agreed, is come to the office prepared to give their doctor all of the relevant information about the nature and timing of their symptoms.
“I do think it’s important for a patient to question or observe the doctor,” Newman-Toker said. “Ask pointed questions: ‘ what else could this be? What things are you most concerned about?’” JAMA Pediatrics.
Researchers at the University of British Columbia in Vancouver wanted to find out how volunteering might impact one’s physical condition, and discovered that it improves cardiovascular health, said study author Hannah Schreier.
And “the volunteers who reported the greatest increases in empathy, altruistic behavior and mental health were the ones who also saw the greatest improvements in their cardiovascular health,” said Schreier.
Previous studies had shown that psychosocial factors, such as stress, depression and well being, play a role in cardiovascular disease, which is a leading cause of death in North America.
Schreier noted that the first signs of the disease can begin to appear during adolescence, which is why she recruited young volunteers for her study.
She and her team measured the body mass index, inflammation and cholesterol levels of 53 Vancouver high school students who spent an hour a week working with elementary school children in afterschool programs in their neighborhood. industry introduces new products, especially those targeting the young. (AFP) 2nd swine flu case in Scotland: Health authorities in Scotland said Tuesday it is dealing with a second case of the H1NI virus - known as swine flu.
An 18-month-old boy was admitted to Dumfries and Galloway Royal Infirmary yesterday.
A 27-year-old woman from Sanquhar, Scotland, is being treated for the virus in a specialist hospital in Leicester, central England.
Dr. Derek Cox, director of public health, is urging anyone in the risk group to be vaccinated against the virus as soon as possible.
He said the child had been admitted with symptoms of swine flu which had been confirmed following tests.
Those with low immune systems and pregnant women are especially at risk.
Jennifer Scott, who was pregnant, remains in a critical but stable condition in hospital. The 27-year-old collapsed at her mother’s funeral and underwent an emergency caesarean before being transferred by helicopter from hospital in Dumfries to the specialist unit at Glenfield Hospital in Leicester last week. Her baby daughter is said to be doing well. (KUNA)