sitemaster Dr Solomon Chollom
Lead Correspondent
Misdiagnosis of diseases is a challenge the health professionals and health institutions have been battling to trace, track and resolve. Everyone talks about it's existence but no one owns up to his culpability in the unfortunate development
Medical diagnosis could be presumptive or definitive. Presumptive diagnosis is made in the clinic by the physician based on clinical presentations. With the case definition of diseases in sight, the physician makes a tentative diagnosis. This forms the basis for the next phase of diagnosis which is the definitive and often obtained from the medical laboratory or other diagnostics points in the hospital.
In the laboratory, the medical laboratory scientist takes the appropriate sample using the prescribe sample collection technique while adhering to quality assurance measures at the pre-analytic phase.
The analysis of the samples then follows. This is done by trained and certified medical laboratory scientists using verifiable protocols with strict concodance with standard operating procedures as stipulated in Laboratory Quality Management System (LQMS) manual to ensure that the outcome of the assay is authentic, reproducible and a perfect reflection of the state of health or otherwise of the patient.
After result has been generated, computation and interpretation is required in some cases using cut off values. The transcription, documentation and transmission of the result to the requesting physician along with clean up and disposal of waste generated during the process of the assay make up the post- analytic phase of laboratory diagnosis. When this is followed religiously, errors in laboratory diagnosis are greatly minimized , if not completely eliminated.
Interestingly, the laboratory competence is expected to be measured periodically when testing laboratories subscribe for external quality assurance (EQA) programs. This ensures that the performance of testing laboratories are check holistically from personnel to operations and to waste management amongst others. Blind samples are sent by accredited national or international laboratories to verify performance of laboratories in their network.
Testing laboratories could also enrol for laboratory accreditation by certified bodies to get accreditation and certification. This is a global requirement for testing laboratories without which they are incompetent to carryout laboratory diagnosis of clinical samples.
Misdiagnosis could occur when the physician fails to make the right tentative diagnosis upon triaging a patient. This means he will end up requesting for the wrong laboratory investigations and in some cases prescribe wrong drugs for treatment.
The laboratory on the other hand which the World Health Organization has maintained that it is responsible for the generation of over 70% of empirical data required for clinical management of diseases could either bring the misfiring physician in track by generating the right clinical data to guide him or further derail him through failure to harken to standard protocols, through sheer ineptitude or through outright conspiracy to short-change or sabotage the diagnostic flow chain through quackery
Misdiagnosis leads the physician astray. He adopts wrong approach to treatment. This comes not only with economic waste on the side of the patient but also as possible breeding ground for antimicrobial resistance when infectious agents are involved. It could also lead to instant death of patients especially when critical assays like blood grouping and crossmatching are done for the purpose of blood transfusion and wrong results are generated
To check the unending cases or misdiagnosis, recruitment of health professionals must be based on competence, continuous professional development of members must also be given priority while acts of prefessional misconduct must be investigated and dealt with accordingly. Also medical laboratories must also be mandated to subscribe to accreditation process to optimize their performance and guarantee efficiency as this will go a long way to eliminate cases of misdiagnosis of diseases
