美国的诊断错误造成的严重伤害负担
David E Newman-Toker1,2, Najlla Nassery3, Adam C Schaffer4,5
1Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA toker@jhu.edu.
据估计,每年有795,000名美国人由于危险疾病的诊断错误而遭受永久性残疾或死亡. 专注于前15个条件可以使这个问题更易于管理.
科学领域:
- 医学错误研究 医学错误研究
- 患者安全 患者安全
- 健康结果分析 分析
背景情况:
- 诊断错误是一个重要的全球公共卫生问题,带来了可预防的重大危害.
- 之前的研究估计了特定危险疾病的诊断错误率,但缺乏全面的负担估计.
- 专家验证被用来确定诊断错误和伤害率的合理范围.
研究的目的:
- 量化美国与错误诊断相关的严重伤害的年度负担,包括永久性发病率和死亡率.
- 结合现有的诊断错误率与疾病发病率数据进行全国估计.
- 评估错误诊断在各种护理环境中的影响.
主要方法:
- 美国国家代表性医院出院数据 (2012-2014) 和癌症登记册 (2014) 的横截面分析.
- 估计血管事件,感染和癌症的年度发病率 ("三大"类别).
- 疾病特异性发病率乘以确定的诊断错误率和严重伤害率,不确定性通过蒙特卡洛模拟量化.
主要成果:
- 据估计,由于误诊,美国每年发生795,000起严重伤害 (永久性残疾或死亡).
- 血管事件,感染和癌症占每年数百万例的病例,加权平均误差和严重伤害率分别为11.1%和4.4%.
- 15种最危险的疾病占总严重伤害的50%以上,其中中风,败血症,肺炎,静脉血栓栓塞和肺癌是最具影响力的.
结论:
- 每年大约有795,000名美国人因错误诊断的危险疾病而遭受永久性残疾或死亡.
- 专注于错误诊断导致的15个主要伤害原因,可以显著提高患者的安全.
- 这些发现强调了有针对性的干预措施的潜力,以减少诊断错误的重大负担.
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