Diagnostic Error in Pediatric Cancer
The purpose of this study was to (a) determine the frequency of diagnostic errors in pediatric cancer, (b) categorize errors, and (c) underscore themes associated with misdiagnosis. This is a retrospective cohort study at a tertiary children’s hospital of 265 patients with new oncologic diagnoses. The diagnostic error rate was 28%. Compared with those with no diagnostic error, those in whom there was an error were more likely to have (a) more visits before diagnosis (P < .001), (b) not been seen in an acute care setting (P = .03), (c) inappropriate treatment (P < .001), and (d) misinterpreted laboratory studies or imaging (P < .001). Themes in diagnostic errors were lack of appropriate evaluation for persistent symptoms (47%), failure to recognize signs and symptoms suggestive of malignancy (45%), and misinterpretation of tests (8%). Clinicians should consider diagnostic evaluation for multiple visits for the same complaint or a constellation of signs and symptoms suggestive of malignancy.