Misdiagnoses in the Context of Suspected Pandemic Influenza or Coronavirus Disease 2019: A Systematic Review

Lucy Bray; Katerina Meznikova; Daniel James; Razan Rislan; Rahul Shah; Pavan Mason; Tim Staniland; Patrick Lillie; Gavin Barlow; Nicholas Easom

doi:10.1093/ofid/ofac515

Misdiagnoses in the Context of Suspected Pandemic Influenza or Coronavirus Disease 2019: A Systematic Review

Lucy Bray, Katerina Meznikova, Daniel James, Razan Rislan, Rahul Shah, Pavan Mason, Tim Staniland, Patrick Lillie, Gavin Barlow, Nicholas Easom^*

^*Corresponding author for this work

The Hull York Medical School

Research output: Contribution to journal › Review article › peer-review

Abstract

There have been numerous reports of patients initially misdiagnosed in the 2009 H1N1 influenza and coronavirus disease 2019 (COVID-19) pandemics within the literature. A systematic review was undertaken to collate misdiagnoses during the H1N1 and COVID-19 pandemics and identify which cognitive biases may contribute to this. MEDLINE, Embase, Cochrane and MedRxiv databases were searched for misdiagnoses or cognitive biases resulting in misdiagnosis, occurring during the H1N1 or COVID-19 virus pandemics. Eligible studies were assessed for quality using JBI criteria; primary outcome was the final diagnosis. Sixty-nine studies involving 2551 participants were included. We identified 686 cases of misdiagnosis, categorized as viral respiratory infection, other respiratory infection, non-respiratory infection, and non-infective. Misdiagnoses are listed and relevant investigations are offered. No article described prospective assessment of decision making in the pandemic setting or debiasing diagnostic thinking. Further research is required to understand why misdiagnoses occur and harm arises and how clinicians can be assisted in their decision making in a pandemic context.

Original language	English
Article number	ofac515
Journal	Open Forum Infectious Diseases
Volume	9
Issue number	11
Early online date	5 Oct 2022
DOIs	https://doi.org/10.1093/ofid/ofac515
Publication status	Published - Nov 2022

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10.1093/ofid/ofac515

ofac515
© The Author(s) 2022
Final published version, 609 KBLicence: CC BY-NC-ND

Cite this

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title = "Misdiagnoses in the Context of Suspected Pandemic Influenza or Coronavirus Disease 2019: A Systematic Review",

abstract = "There have been numerous reports of patients initially misdiagnosed in the 2009 H1N1 influenza and coronavirus disease 2019 (COVID-19) pandemics within the literature. A systematic review was undertaken to collate misdiagnoses during the H1N1 and COVID-19 pandemics and identify which cognitive biases may contribute to this. MEDLINE, Embase, Cochrane and MedRxiv databases were searched for misdiagnoses or cognitive biases resulting in misdiagnosis, occurring during the H1N1 or COVID-19 virus pandemics. Eligible studies were assessed for quality using JBI criteria; primary outcome was the final diagnosis. Sixty-nine studies involving 2551 participants were included. We identified 686 cases of misdiagnosis, categorized as viral respiratory infection, other respiratory infection, non-respiratory infection, and non-infective. Misdiagnoses are listed and relevant investigations are offered. No article described prospective assessment of decision making in the pandemic setting or debiasing diagnostic thinking. Further research is required to understand why misdiagnoses occur and harm arises and how clinicians can be assisted in their decision making in a pandemic context.",

author = "Lucy Bray and Katerina Meznikova and Daniel James and Razan Rislan and Rahul Shah and Pavan Mason and Tim Staniland and Patrick Lillie and Gavin Barlow and Nicholas Easom",

note = "{\textcopyright} The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.",

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AU - Rislan, Razan

AU - Shah, Rahul

AU - Mason, Pavan

AU - Staniland, Tim

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AU - Barlow, Gavin

AU - Easom, Nicholas

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N2 - There have been numerous reports of patients initially misdiagnosed in the 2009 H1N1 influenza and coronavirus disease 2019 (COVID-19) pandemics within the literature. A systematic review was undertaken to collate misdiagnoses during the H1N1 and COVID-19 pandemics and identify which cognitive biases may contribute to this. MEDLINE, Embase, Cochrane and MedRxiv databases were searched for misdiagnoses or cognitive biases resulting in misdiagnosis, occurring during the H1N1 or COVID-19 virus pandemics. Eligible studies were assessed for quality using JBI criteria; primary outcome was the final diagnosis. Sixty-nine studies involving 2551 participants were included. We identified 686 cases of misdiagnosis, categorized as viral respiratory infection, other respiratory infection, non-respiratory infection, and non-infective. Misdiagnoses are listed and relevant investigations are offered. No article described prospective assessment of decision making in the pandemic setting or debiasing diagnostic thinking. Further research is required to understand why misdiagnoses occur and harm arises and how clinicians can be assisted in their decision making in a pandemic context.

AB - There have been numerous reports of patients initially misdiagnosed in the 2009 H1N1 influenza and coronavirus disease 2019 (COVID-19) pandemics within the literature. A systematic review was undertaken to collate misdiagnoses during the H1N1 and COVID-19 pandemics and identify which cognitive biases may contribute to this. MEDLINE, Embase, Cochrane and MedRxiv databases were searched for misdiagnoses or cognitive biases resulting in misdiagnosis, occurring during the H1N1 or COVID-19 virus pandemics. Eligible studies were assessed for quality using JBI criteria; primary outcome was the final diagnosis. Sixty-nine studies involving 2551 participants were included. We identified 686 cases of misdiagnosis, categorized as viral respiratory infection, other respiratory infection, non-respiratory infection, and non-infective. Misdiagnoses are listed and relevant investigations are offered. No article described prospective assessment of decision making in the pandemic setting or debiasing diagnostic thinking. Further research is required to understand why misdiagnoses occur and harm arises and how clinicians can be assisted in their decision making in a pandemic context.

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