Fereshte Sheybani
Mashhad University of Medical Sciences, Iran
Title: Diagnostic errors in tuberculous patients: A multicenter study from a developing country
Biography
Biography: Fereshte Sheybani
Abstract
Although there is still much to learn about the types of errors committed in health care and why they occur, enough is known today to recognize that a serious concern exists for patients. Tuberculosis (TB) is an infectious disease that is frequently subject to diagnostic errors. Missed or delayed diagnosis of TB can affect patients and community adversely. The current is a multicenter study that was conducted in three university hospital in Mashhad, Iran. We tried to evaluate the type of diagnostic errors in TB patients from symptom onset to diagnosis. Errors in the diagnostic process were identified in 97.5% of patients. Although an important part of the delay in diagnosis of TB was related to the delay from onset of symptoms until the first medical visit by patient, but more significant part was associated with delayed time from first medical visit to diagnosis, which was associated with diagnostic errors. Similar to other diagnostic errors, in the TB patients, a combination of cognitive and system errors led to a delayed or missed diagnosis. The most common type of error in diagnosing TB was failure in hypothesis generation (72%), followed by history taking and physical examination. It seems likely that efforts to improve public awareness of and health literacy for TB, to coordinate the referral and follow up systems of patients and to improve physicians' skills in history taking and physical examination and clinical reasoning will result in reduced delay in diagnosis of TB and perhaps, improved patient safety and community health.