Causes, frequency and avoidance of diagnostic errors in newborns and children of the first year of life

Abstract

The article presents research methods to detect the frequency of diagnostic errors.Objective: to compare clinical and pathological diagnoses in order to determine the frequency, causes and ways of avoiding diagnostic errors in children with infectious pathology specific to the perinatal period. The authors studied 234 death cases in the intensive care unit for newborns in 2006–2018, and they found diagnostic errors in 18,3% of cases. 53,4% of the diagnostic errors were associated with unrecognized infectious diseases specific to the perinatal period. The authors found that the correct intravital diagnosis was impossible for objective reasons in 65% of cases. Those objective reasons were mainly caused by diagnostic difficulties due to the lack of characteristic clinical data or the atypical course. Almost in every third patient the diagnostic errors were caused by subjective reasons and were associated with the diagnosis of congenital cytomegalovirus infection and neonatal sepsis. The subjective errors were often caused by the so-called doctor’s bona fide delusion due to a lack of knowledge, skills, experience. As the judgment error was the most common reason for misdiagnosis we need to improve the clinicians’ cognitive condition. Based on the audit results, the authors proposed the additional diagnostic approaches for certain diseases. One way to reduce errors is to improve educational initiatives for doctors.