Two decades of autopsy-detected diagnostic errors in Japan.

IF 2 Q2 MEDICINE, GENERAL & INTERNAL

Diagnosis Pub Date : 2025-04-11 eCollection Date: 2025-08-01 DOI:10.1515/dx-2025-0013

Kohta Katayama, Tomoharu Suzuki, Maho Adachi-Katayama, Kenji Numata, Yuki Honda, Hiroyuki Nagano, Yuki Hiramatsu, Takashi Watari, Yasuharu Tokuda, Payal K Patel, Yoshiyuki Ohira

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引用次数: 0

Abstract

Objectives: Autopsy plays an essential role in detecting diagnostic errors and the findings from autopsies have the potential to reduce future errors. However, there are few reports from Japan on diagnostic errors based on autopsy diagnoses. This study aimed to detail diagnostic errors in autopsy reports in Japan.

Methods: This descriptive study utilized the case report abstract database of the Japanese Society of Internal Medicine chapter meetings. Autopsy cases from 2002 to 2022 were included. We defined diagnostic errors as discrepancies in the primary cause of death between autopsy and clinical diagnosis. Diagnostic error cases were also categorized according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). To observe trends, a chi-square test was conducted by dividing the 20 years of data into four groups.

Results: Among 1,213 autopsied cases, diagnostic errors occurred in 435 cases (35.9 %; 95 % confidence interval, 33.2-38.6 %). The most frequent category of autopsy-detected diagnostic error cases was neoplasms (147, 33.8 %), followed by infections (131, 30.1 %), and cardiovascular diseases (49, 11.3 %). Over the 20 years, the incidence of diagnostic errors neither increased nor decreased.

Conclusions: Diagnostic errors detected in 35.8 % of autopsy cases in Japan. Autopsy is an important quality indicator for identifying diagnostic error.

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日本二十年的尸检诊断错误。

目的：尸检在发现诊断错误中起着至关重要的作用，尸检的结果有可能减少未来的错误。然而，日本很少有基于尸检诊断的诊断错误的报道。本研究旨在详细分析日本尸检报告中的诊断错误。方法：采用日本内科学会分会会议病例报告摘要数据库进行描述性研究。包括2002年至2022年的尸检病例。我们将诊断错误定义为尸检和临床诊断之间主要死因的差异。还根据国际疾病和相关健康问题统计分类（ICD-10）第十次修订版对诊断错误病例进行分类。为了观察趋势，将20年的数据分为四组，进行卡方检验。结果：1213例尸检中，诊断错误435例(35.9 %；95 %置信区间，33.2-38.6 %)。最常见的尸检诊断错误类型是肿瘤（147例，33.8 %），其次是感染（131例，30.1 %）和心血管疾病（49例，11.3 %）。20年来，诊断错误的发生率既没有增加也没有减少。结论：在日本，35.8% %的尸检病例中检出诊断错误。尸检是鉴别诊断错误的重要质量指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnosis MEDICINE, GENERAL & INTERNAL-

CiteScore

7.20

自引率

5.70%

发文量

期刊介绍： Diagnosis focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality.　 Topics: -Factors that promote diagnostic quality and safety -Clinical reasoning -Diagnostic errors in medicine -The factors that contribute to diagnostic error: human factors, cognitive issues, and system-related breakdowns -Improving the value of diagnosis – eliminating waste and unnecessary testing -How culture and removing blame promote awareness of diagnostic errors -Training and education related to clinical reasoning and diagnostic skills -Advances in laboratory testing and imaging that improve diagnostic capability -Local, national and international initiatives to reduce diagnostic error