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Obtaining an accurate diagnosis is a critical component of healthcare as it provides an understanding or interpretation of a patient’s health issue, guiding subsequent healthcare choices.
The process of diagnosis involves identifying the type of ailment, disorder, or issue by analyzing signs and symptoms to differentiate it from other potential conditions.
Arriving at a diagnosis requires gathering a medical history, conducting a physical examination, ordering diagnostic tests, and synthesizing all acquired information to determine the likely cause of the health problem.
Diagnostics encompass medical instruments, techniques, and procedures utilized for the in vitro and in vivo assessment of physiological conditions or the presence and details of a disease, according to the World Health Organization (WHO).
Laboratory tests (like blood or urine tests) are examples of in vitro diagnostics, while imaging tests (like chest radiography, mammography, or pelvic ultrasound), along with tools such as thermometers, electrocardiograms, pulse oximeters, endoscopes, or blood pressure monitors, are categorized under in vivo diagnostics.
However, misdiagnosis—incorrectly identifying a condition or disease—may happen, resulting in numerous challenges for patients and healthcare providers. Health practitioners have raised concerns, recognizing that the reasons could be numerous and require a cooperative approach to resolve.
A Consultant Radiologist who spoke with journalist, Dr. Caleb Yakubu, noted various factors that might contribute to medical misdiagnosis, which could adversely affect a patient's health.
Yakubu, who also oversees the One-Stop-Breast Clinic at Lagos University Teaching Hospital (LUTH), stated that misdiagnosis could arise from using faulty or substandard equipment.
Additionally, he pointed out that some laboratory staff, in pursuit of profit, sometimes compromise the quality of diagnostics by employing counterfeit and subpar apparatus for medical diagnoses. "Such medical examinations might ultimately lead to misdiagnosis," he remarked.
He added that outdated equipment could also contribute to misdiagnosis since numerous private and public health institutions may not afford to upgrade to modern technology. According to him, another contributing factor is that certain laboratory staff may lack the necessary skills and expertise to effectively conduct specific types of diagnoses.
“Occasionally, the diagnostic kits and reagents might be counterfeit, and due to selfish profit motives, medical personnel may utilize such equipment for patient diagnoses, resulting in misdiagnosis or medical error. Similarly, many diagnostic kits not only lack authenticity but are also of inferior quality, making it easier for medical personnel to arrive at incorrect diagnoses.
“For example, with counterfeit diagnostic kits and reagents, a pregnant woman might receive a negative pregnancy test. The same scenario can occur with malaria and other illnesses. The use of fake or substandard kits may also yield positive results when they should be negative,” he elaborated.
To address misdiagnosis, Yakubu advocated for stricter regulations on the importation of diagnostic kits to ensure that only certified and standardized products are permitted into the nation.
He also emphasized the need for capacity development and thorough training of medical and laboratory personnel to enhance their competencies.
Highlighting the ramifications of misdiagnosis, Dr. Albert Eze state it negatively impacts patients' mental and physical well-being. “It results in unnecessary and avoidable treatments. In some cases, patients might take unnecessary medications, leading to other health issues or even death. Some ‘victims’ may undergo surgeries and treatments that are not required,” he mentioned.
Contributing further, a Mental Health Physician, Dr. Maymunnah Kadiri, acknowledged that unnecessary medical interventions can also have a psychological impact on patients. “Such situations can instigate fear and trauma, potentially lead to hypertension, stroke, or heart attacks, and if not addressed appropriately, can even result in death.
“In addition to the physical harm and emotional upheaval, misdiagnosis places a substantial financial burden on patients and their families,” stated Kadiri, who also serves as a Consultant Neuro-Psychiatrist.
A Medical Imaging Scientist, Dr. Livinus Abonyi, provided suggestions to combat misdiagnosis, emphasizing the urgent need for adequate funding for healthcare facilities and a robust National Health Insurance Scheme (NHIS) in the country.
Abonyi identified limited investigations—which may result from using obsolete or inferior equipment, inadequate funding, absence of experienced personnel, or excessive pursuit of profit—as a significant reason behind misdiagnosis.
As the Head of the Radiography Department at the Faculty of Clinical Sciences, College of Medicine, University of Lagos, he explained that sufficient funding could mitigate issues related to outdated equipment and the training of personnel, among other factors contributing to misdiagnosis. He pointed out that many patients lack the financial means to afford necessary medical investigations, which underscores the importance of NHIS in alleviating medical expenses for the population.
Abonyi clarified that there exists legislation mandating various companies and organizations to contribute to the health funding of Nigerian citizens, regrettably stating that only about 10 percent of this Act has been enforced.
He remarked that enforcement of this legislation would allow an average citizen to access essential medical investigations and treatments at minimal or no cost. He called for the Act to be revitalized and enforced diligently while urging that everyone should participate in the health insurance scheme and that all responsible stakeholders begin to contribute.
"It is not inevitable that everyone will fall ill at the same time; the resources generated would be sufficient to cover the percentage of individuals who require care at any moment. This is the approach adopted by developed nations, who prioritize their citizens' welfare. The lack of action from Nigeria in this regard will continue to burden ordinary citizens, consequently perpetuating misdiagnosis due to many being unable to afford necessary diagnoses,” Abonyi cautioned.
He highlighted that current data indicates that over 75 percent of medical treatment costs are paid out-of-pocket by citizens. "This is unacceptable; it should be the other way around. Health insurance should ideally cover about 80 percent of treatment and diagnostic costs, while the remaining minimal percentage is borne by individuals.
“With this, an average citizen walking down the street can be assured of surviving until the next day, next month, or next year,” he said, urging the government to prioritize the NHIS.
Furthermore, a Laboratory Scientist, Olamide Fadipe, insisted that patients and their families also play a role in ensuring accurate medical diagnoses.
Fadipe emphasized that accurate diagnosis is crucial for the effective management of patients and diseases, urging patients to provide truthful information regarding their health conditions.
He identified wasted resources, heightened mortality rates, extended hospital stays, death, psychological distress on patients and families, and increased strain on healthcare workers as some of the consequences of misdiagnosis.
Fadipe, who previously chaired the Association of Medical Laboratory Scientists of Nigeria (AMLSN) in Lagos State, encouraged laboratory personnel to reject any compromises and consistently prioritize the well-being of their patients. Collectively, the experts concluded that the impacts of misdiagnosis on patients extend beyond the initial diagnostic inaccuracies.
The physical, emotional, and financial burdens are immeasurable, necessitating urgent action to address the root causes of misdiagnosis. It is also critical to implement and oversee strategies to enhance diagnostic accuracy within the healthcare system to prevent the illnesses and fatalities that may result from misdiagnoses, they advised.
