A new report finds millions of people in New Jersey and across the country who go to a hospital emergency room every year wind up getting misdiagnosed.

Many leading healthcare experts and organizations are calling the report inaccurate and misleading.

The report, by the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services, finds almost 6% of ER patients, a total of more than 7 million, get an incorrect diagnosis, and some wind up disabled or dead.

Extremely flawed report?

Several leading emergency physician groups, including the American College of Emergency Physicians and the American Board of Emergency Medicine, have protested the report, describing it as misleading.

Dr. Lewis Nelson, the Chair of Emergency Medicine at the Rutgers New Jersey Medical School, said the information presented is extremely flawed.

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He pointed out researchers based the conclusions in their report on close to 300 different studies done of ER departments from the year 2000 to 2021 and “the data were actually not even derived from the United States. These (data sets) were derived from Spain and other European countries over that 20-year period.”


He said if you look at emergency medicine practiced in the United States, where physicians get specialized training and are board certified, and compare it to countries “that reflect American emergency medicine from 30 or 40 or 50 years ago in terms of their training and qualifications, again (it) makes this a very flawed comparison, something that I don’t think really holds true.”

Nelson said tremendous technological advances have been made in medicine since 2000 that have greatly improved diagnoses, which is another reason the report is misleading.

He said if somebody suddenly becomes seriously ill or has an accident, “going to an emergency department is really the only option that you’re going to have, and there’s no alternative that’s going to provide a better place to seek care and to get a better work-up and diagnosis in short order.”

According to the report, the top five misdiagnosed conditions in the ER were:

• Stroke
• Myocardial infarction
• Aortic aneurysm/dissection
• Spinal cord compression/injury
• Venous thromboembolism

Nelson said that when patients come into the ER, they frequently have a wide variety of serious conditions in very complicated circumstances, and the initial effort by doctors is not to come up with a final diagnosis but to rule out causes that might be life-threatening.

“So when somebody is given a diagnosis that may ultimately turn out to be wrong, that doesn’t mean it was a misdiagnosis. It meant it was a preliminary diagnosis with an intent to continue to work up until we found the right answer.”

He said there is always room for improvement but “if you’re sick and you need to be seen emergently or urgently you need to go to an emergency department unless you have an alternative, perhaps you have a doctor that’s going to take care of you, (if not) you have to go to the emergency department.”

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