Reflections on misdiagnosis.

Abstract

It is correct to speak of misdiagnosis when, at the end of the diagnostic procedure, a disease which could not be proved by autopsy is assumed by the physician to be present; furthermore, when the non-recognition of the true disease leads to a worsening of the patient's prognosis. In contrast, the false positive and the false negative diagnoses have no prognostic relevance. The introduction of new diagnostic technology, such as sonography, scintigraphy and computer tomography, has not reduced the frequency of misdiagnosis appreciably within the last 20 years: now, just as before, its incidence appears to be about 10%. Over-reliance on the new procedures occasionally contributes directly to misdiagnosis.