What Kenya can do to reduce often costly processing errors

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Well-being and fitness

What Kenya can do to reduce often costly processing errors


What Kenya can do to reduce often costly processing errors. PICTURES | SHUTTER

Proper diagnosis of diseases is crucial for good health care outcomes. A misdiagnosis can be costly to the patient at best and fatal at worst. But despite the high stakes, misdiagnoses are not uncommon. Such errors creep into pathology and laboratory medicine.

A laboratory misdiagnosis is when a wrong laboratory result is given to a patient. It can also be defined as a laboratory result that does not meet expectations in terms of accuracy, timeliness, interpretation, or does not reflect what is happening to the patient.

An erroneous result may be due to an error in sample collection, sample measurement, or recording and reporting of the patient result.

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Such mistakes can be life threatening. For example, approximately 30% of TB patients go undiagnosed, contributing to the 1.5 million annual deaths worldwide.

Treatment without a confirmed laboratory diagnosis can also lead to the unnecessary use of antibiotics and antimalarial drugs. There are also cases of people being misdiagnosed as HIV-positive due to the use of unapproved test kits.

Usually, in the absence of good laboratory diagnoses, health care providers rely on clinical judgment (syndromic diagnosis), an approach particularly common at the primary health care level. However, this therapeutic approach is dangerous because it assumes that diseases always present very specific symptoms.

The lack of a systems approach to ensuring the safety and quality of diagnostics can lead to patient harm and wasted resources.

A systems approach involves quality improvement processes that ensure that laboratory equipment, personnel and procedures are of the highest quality from the time a test is ordered through collection, transport , treatment, analysis, reporting of results and dissemination of these results to the appropriate physician in a timely manner.

Failure of any of the above processes can lead to diagnostic errors.

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To reduce misdiagnosis, a national regulatory framework that addresses safety and quality is essential. New diagnostic tools and screening tests must be validated against a gold standard and their use must be regulated appropriately.

Implementation of a quality service will require that the laboratory adheres to quality standards and regulatory authorities make it mandatory that each laboratory be accredited for all the tests it performs and that all personnel working within these laboratories have the qualifications and professional skills required.

Advocacy for diagnosis to be an integral part of any universal health coverage program should be a priority if we are to achieve SDG 3.

Dr Shahin Sayed, Head of Department of Pathology and Pathology, Dr Geoffrey Omuse and Dr Daniel Maina, Clinical Pathologists at Aga Khan University Hospital, Nairobi

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