Analysis of misdiagnosis and missed diagnosis after gastrointestinal endoscope and related risk factors: a population-based analysis
LI Shu-hui
ZHOU Huan-ming
ZHANG Ai-qin
XU Chun-lan
HOU He-bin
JIN Xi-feng
CHAI Tong-hai
LIU Chun-an
Abstract：Objective To evaluate the frequency and risk factors for the missed diagnosis and misdiagnosis rate in the examination of gastrointestinal endoscopes and to explore the methods to decrease it in our district. Methods The relevant data were collected from the inpatients and outpatients who underwent colonoscopy or gastro-scope over the past 5years. Related Chinese literatures published were retrieved. A Comparative Analysis was con-ducted. Results Independent risk factors for the location of lesions were gastric fundus and cardiac part, the upper esophagus, gastric antrum, descending part of duodenum older age(Crude OR:1, 1.02, 0.81,0.95, P<0.05). Some environment factors, such as the inadequacy of gastrointestinal endoscopy preparation, the lack of assistants, the low grade of hospital, the poor medical equipment (Crude OR:1, 1.69, 0.95, 1.10, P<0.05), which impact the missed diagnosis and misdiagnosis rats. The level of recognition of some uncommon and atypical diseases were divided into three grade: good, fit and poor (Crude OR:1, 1.94, 1.23, P<0.05). Clinical factors relating to the success of the procedure were including: more blind area, incomplete examination, the endoscopist nonstandard biopsy, without biopsy underwent, indeterminacy of pathological and histochemical changes (Crude OR:1, 2.39, 0.76, 1.69, 1.25, 4.31, P<0.05). In addition, the patient characteristic strongly associated with a new or missed lesions were cognition of disease progression and cooperating with doctors (Crude 1, 1.19, P>0.05). Conclusions The missed diagnosis and misdiagnosis rates of gastrointestinal diseases were associated with the following factors: baseline characteristics of subjects, lesion sites, the experience of the physicians, the adequacy of bowel preparation, and the gastroenterological endoscope setting etc. several technical innovations such as endoscop-ic ultrasonography (EUS), chromoscopy, magnifying endoscopy, upper gastrointestinal Barium opacification and abdominal CT could be used to reduce missing and to increase diagnosis rate.
Keywords：Gastrointestinal endoscopesMiadiagnosis and missed diagnosisRelevant factorsStandardize operations
Publication Date：2010-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：3( 330-332 )