[Errors in the diagnosis of peptic ulcer]

Area of Science:

• Gastroenterology
• Medical Diagnostics
• Clinical Epidemiology

Background:

• Peptic ulcer disease remains a common gastrointestinal condition.
• Accurate diagnosis is essential for effective management and patient outcomes.
• Diagnostic errors can lead to delayed or inappropriate treatment.

Purpose of the Study:

• To compare diagnostic accuracy for peptic ulcers between polyclinics and gastroenterology clinics.
• To identify the types and rates of diagnostic errors in gastric and duodenal ulcers.
• To investigate the factors contributing to misdiagnosis of peptic ulcers.

Main Methods:

• Retrospective analysis of 2515 patients with peptic ulcer diagnoses.
• Comparison of diagnoses made at polyclinics versus gastroenterology clinics.
• Categorization of diagnostic errors into underdiagnosis and overdiagnosis.

Main Results:

• Overall erroneous diagnoses were 24.8% for gastric ulcers and 15.1% for duodenal ulcers.
• Gastric ulcer diagnosis had a significantly lower accuracy than duodenal ulcer diagnosis (p<0.01).
• Overdiagnosis rates were higher than underdiagnosis rates for both ulcer types.

Conclusions:

• Diagnostic errors in peptic ulcer disease are prevalent, particularly for gastric ulcers.
• Common misdiagnoses include incorrect ulcer localization, gastritis, duodenitis, and biliary diseases.
• Contributing factors include underestimation of symptom changes, flawed data assessment, and patient-specific factors like age and comorbidities.