Analysis of the accuracy of clinical diagnosis in an internal medicine department of a regional hospital: Inter-MONF study

Abstract

Introduction

There are numerous studies examining the diagnostic accuracy of various supplementary tests; however, the literature focused on diagnostic accuracy derived from clinical reasoning and data is limited. Consequently, we conducted a study to assess the diagnostic accuracy of the professionals in the Internal Medicine Department at our hospital and to examine whether there are variations in accuracy related to specific pathologies and across different time periods, particularly before and after the emergence of the SARS-CoV-2 pandemic.

Methods

This is a retrospective, longitudinal, and observational study conducted in the Internal Medicine Department of the Regional Hospital of Monforte de Lemos from 2016 to 2022, encompassing both pre- and post-SARS-CoV-2 pandemic periods. The initial diagnosis made upon patient admission was compared with the final diagnosis at discharge through an independent peer review process.

Results

The diagnostic concordance at admission and discharge was 77.4%, with statistically significant differences observed between age groups (with higher concordance in patients under 55 years of age) and according to sex, with greater concordance in female patients. No differences were found regarding pathology type or temporal cohort.

Conclusions

The diagnostic accuracy of the healthcare professionals in the Internal Medicine Department at Monforte Public Hospital during the study periods was found to be high. Diagnostic concordance was greater in female patients and those under 55 years of age, with no significant differences observed across the most prevalent pathological conditions. Furthermore, the restrictive measures implemented during the SARS-CoV-2 pandemic do not appear to have negative affected diagnostic accuracy when compared to previous periods.