OBJECTIVES:

Diagnostic errors have become an important patient safety concern especially in the emergency department (ED). This article is aimed at examining the real importance and the role of clinical history in missed diagnoses with diagnostic radiologic process in the ED.

METHODS:

In this multicenter study, a total of 2921 patients were investigated for missed diagnosis who were admitted to the ED from December 2007 to November 2008. Medical records were reviewed; complete medical history of the patients, initial diagnosis and final diagnosis were evaluated, CT and/or MRI findings were assessed as radiologic reinvestigation retrospectively.

RESULTS:

We found that 119 patients (4,07 %) had different initial pre-diagnosis from end-diagnosis in medical records. Our study includes 25 patients (0,85 %) (10 female, 14 male, mean age: 46,7 years) among them with CT and/or MRI investigations regarding the methodology. The basic crucial cause of breakdown was obtained as lack of clinical history for establishing end-diagnosis in all patients even with the assistance of high technology imaging methods.

CONCLUSION:

Although it seems time-consuming at first sight, greater focus is needed on clinical history. Awareness of the validity of the patient history before today’s impressing technical methods can be life saving and fasten the evaluation algorithm in the emergency conditions.

Keywords: