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The gaps in specialists’ diagnoses

Ian A Scott and Donald A Campbell
Med J Aust 2018; 208 (5): 196-197. || doi: 10.5694/mja17.00905
Published online: 19 March 2018

Specialists need broad expertise in diagnosing clinical problems arising from diseases involving different organ systems

On average, about 10% of primary care visits result in a referral to a specialist,1 and of these, up to half relate to diagnostic uncertainty.2 Diagnostic error is estimated to occur in between 10% and 15% of clinical encounters.3 Medicolegal concerns loom large around missed or delayed diagnosis of potentially serious conditions such as heart disease or cancer. Patients often present with non-specific symptoms and signs, especially in the early stages of emerging illness, which can be accentuated in the complex context of multiple comorbidities, frailty or other disabilities. Accordingly, a broad differential diagnosis that includes diseases of more than one organ system has to be considered, followed by a recursive refinement of diagnostic probability in the face of uncertainty.

  • Ian A Scott1,2
  • Donald A Campbell3

  • 1 Princess Alexandra Hospital, Brisbane, QLD
  • 2 University of Queensland, Brisbane, QLD
  • 3 Monash Health, Melbourne, VIC


Competing interests:

No relevant disclosures.

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