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

Abstract

Although there is still much to learn about the types of errors committed in health care and why they occur, enough is known<br><br>today to recognize that a serious concern exists for patients. Tuberculosis (TB) is an infectious disease that is frequently subject<br><br>to diagnostic errors. Missed or delayed diagnosis of TB can affect patients and community adversely. Our aim in the present<br><br>study was at evaluating the type of diagnostic errors in TB patients from symptom onset to diagnosis. This was a multicenter<br><br>cross-sectional study conducted in three university hospitals in Mashhad, Iran. We showed a long delay in diagnosing TB that<br><br>is mostly related to the time from first medical visit to diagnosis. Errors in the diagnostic process were identified in 97.5% of<br><br>patients. The most common type of error in diagnosing TB was failure in hypothesis generation (72%), followed by history<br><br>taking and physical examination. In conclusion, it seems likely that efforts to improve public awareness of and health literacy<br><br>for TB, to coordinate the referral and follow-up systems of patients, and to improve physicians’ skills in history taking and<br><br>physical examination and clinical reasoning will result in reduced delay in diagnosis of TB and, perhaps, improved patient<br><br>1 safety and community health.