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Diagnostic Errors in Tuberculous Patients: A Multicenter Study from a Developing Country.

Hashem Neshati1, Fereshte Sheybani2,3, HamidReza Naderi2

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Diagnostic errors in tuberculosis (TB) are common, with 97.5% of patients experiencing delays. The most frequent error involves failure in hypothesis generation, impacting patient safety and community health.

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Area of Science:

  • Medical Diagnostics
  • Public Health
  • Infectious Diseases

Background:

  • Healthcare-associated errors pose significant risks to patient safety.
  • Tuberculosis (TB) is an infectious disease often affected by diagnostic errors, leading to adverse patient and community outcomes.

Purpose of the Study:

  • To evaluate the types of diagnostic errors in tuberculosis patients from symptom onset to diagnosis.
  • To identify the primary sources of diagnostic delays in TB cases.

Main Methods:

  • A multicenter, cross-sectional study was conducted across three university hospitals in Mashhad, Iran.
  • Data were collected on the diagnostic process from symptom onset to confirmed diagnosis for TB patients.

Main Results:

  • A substantial delay in diagnosing TB was observed, primarily occurring between the first medical visit and the final diagnosis.
  • Diagnostic errors were identified in 97.5% of the studied TB patients.
  • The most prevalent diagnostic error was a failure in hypothesis generation (72%), followed by issues in history taking and physical examination.

Conclusions:

  • Improving public awareness and health literacy regarding TB is crucial.
  • Enhancing coordination in patient referral and follow-up systems can reduce diagnostic delays.
  • Strengthening physicians' skills in history taking, physical examination, and clinical reasoning is essential for improving TB diagnosis and patient safety.