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This article originally posted 08 March, 2011 and appeared in  Safety and Error PreventionIssue 564

One in 20 Diabetes Diagnoses a 'Serious Error'

UK physicians have been told to review all of their patients with diabetes to identify the one in 20 patients that research suggests may have been misdiagnosed or incorrectly classified with the disease....
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The results of an extensive analysis of practice registers, conducted by the RCGP, found 5% of the records of patients with diabetes had 'important errors,' including misdiagnosis, misclassification or miscoding.  

The research, by GP experts in diabetes and primary care informatics, audited data for around a million patients in two primary care databases and identified that overall, 85-90% of data on diabetes is fit for purpose, "but that there is room for improvement."

An audit of five practices in southeast England with a combined list size of approximately 45,000 found that: 2.2% of people diagnosed with diabetes in primary care did not have the condition; 2.1% of patients were classified with the wrong type of diabetes; and 0.9% had their type of diabetes coded as 'indeterminable'.

This means, in an average practice, for every 500 people identified with diabetes on a practice register, between 65 and 70 will need to be looked at "for some sort of error."

Of the 65-70 people, 7-16 cases will be where the wrong sort of diabetes has been diagnosed, the majority of which will be incorrectly diagnosed Type 1 diabetes when the person really has Type 2 diabetes.

About 21 people will be incorrectly diagnosed with diabetes when they do not have it, and there will be 24-37 miscodings.

"Overall the effect of the audit was to change the diagnosis of around a quarter of the people identified," the report concludes.

Stone MA, Camosso-Stefinovic J, Wilkinson J, de Lusignan S, Hattersley AT, Khunti K. Incorrect and incomplete coding and classification of diabetes: a systematic review. Diabet Med. 2010 May;27(5):491-7. PMID: 20536944

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This article originally posted 08 March, 2011 and appeared in  Safety and Error PreventionIssue 564

Past five issues: Diabetes Clinical Mastery Series Issue 207 | Issue 747 | Diabetes Clinical Mastery Series Issue 206 | SGLT-2 Inhibitors Special Edition September 2014 | Issue 746 |


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