Missed test results are a 'substantial problem,' writes DR MUIRIS HOUSTON
UP TO three-quarters of hospital tests are not being adequately followed up, leading to missed diagnoses and other serious implications for patients, research published this morning suggests.
Researchers from the University of New South Wales in Sydney, Australia, examined all studies into missed test results published in 1990-2010 and found a wide variation in the extent of the problem and its impact on patients.
A lack of follow-up of test results for inpatients ranged from 20 per cent to 60 per cent, while one study of patients treated in an emergency department found that 75 per cent of tests had not been properly followed up.
A study of clinical negligence claims found that some 79 of the 112 claims involved missed diagnoses in emergency care that resulted in harm to the patient. The range of tests involved included blood tests and diagnostic imaging such as X-rays and scans.
In a finding directly relevant to recent events in the Republic, a study of radiology follow-up using an e-mail alert system for important but not urgent imaging findings reported that 20 per cent of electronic reports were not viewed by the referring physician.
The Hayes investigation into unreported X-rays in Tallaght hospital last year found evidence of 57,921 unreported X-ray films going back to 2003.
In the case of Ann Moriarty, a breast cancer patient at Ennis hospital, a 2009 report found that abnormal blood test results, strongly suggestive of breast cancer recurrence, were filed in her chart without being acted on.
The research, published in the BMJ Quality and Safety journal, points to a particular problem for patients moving across healthcare settings, for example from inpatients to outpatients and when patients are discharged to GPs.
Specific consequences included missed cancer diagnosis, failure to diagnose osteoporosis and the results of laboratory tests indicating a need to commence or change antibiotic treatment not being followed up.
“There is evidence to suggest that the proportion of missed test results is a substantial problem, which impacts on patient safety,” Dr Joanne Callen and her co-authors conclude.