Misdiagnosis of pneumoconiosis or silicotuberculosis in China: a pooled analysis of 1178 cases

Abstract

To investigate the situation and causes of misdiagnosis of pneumoconiosis or silicotuberculosis in China by pooled analysis, and to provide a reference for the clinical diagnosis of pneumoconiosis in China and reduce the misdiagnosis rate. A computer search was performed to collect the studies on the misdiagnosis of pneumoconiosis or silicotuberculosis published in China from 1985 to 2013. The obtained data were subjected to pooled analysis to investigate the causes of misdiagnosis and seek the measures for reducing misdiagnosis. Fifty-nine studies involving 1178 cases of misdiagnosed pneumoconiosis or silicotuberculosis were collected. There were 13 causes of misdiagnosis, and the most common one was the poor ability of identification due to inadequate experience in reading chest X-ray films (45.93%), followed by neglect of patient's occupational history (44.99%). Other causes of misdiagnosis included complex X-ray findings that are difficult to judge (29.03%), poor quality of chest radiographs (23.09%), and lack of regular health supervision (19.95%). Inadequate experience of physicians is the main cause of misdiagnosis of pneumoconiosis or silicotuberculosis. To reduce misdiagnosis of the disease, measures should be taken to enhance the training and evaluation of knowledge and skills of diagnosis and differential diagnosis of pneumoconiosis among physicians.