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Misdiagnosis in occupational and environmental medicine: a scoping review

Cited 1 time in Web of Science Cited 0 time in Scopus
Issue Date
2021-08-24
Publisher
BMC
Citation
Journal of Occupational Medicine and Toxicology. 2021 Aug 24;16(1):33
Keywords
Occupational and environmental medicineOccupational diseaseEnvironmental diseaseMisdiagnosisScoping review
Abstract
Introduction
There has been no comprehensive review for misdiagnosis in Occupational and Environmental Medicine (OEM). The possible ramifications of an occupational disease (OD) or an environmental disease (ED) misdiagnosis are not just confined to the individual case but may extend to others exposed to the occupational or environmental hazard. Therefore, a comprehensive scoping review of published literature is imperative for understanding the nature of misdiagnoses in OEM.

Methods
A medical librarian searched MEDLINE (PubMed), EMBASE, and the Cochrane Library (on 06 November 2020). All collected OEM misdiagnoses were classified based on 2 conceptual frameworks, the typical framework, and the causation model. The distribution of misdiagnosis across each medical specialty, each diagnostic step of the typical framework and the causation model, and false-negative and false-positive were summarized.


Results
A total of 79 articles were included in the scoping review. For clinical specialty, pulmonology (30 articles) and dermatology or allergy (13 articles) was most frequent and second-most frequent, respectively. For each disease, occupational and environmental interstitial lung diseases, misdiagnosed as sarcoidosis (8 articles), and other lung diseases (8 articles) were most frequent. For the typical framework, the most vulnerable step was the first step, evidence of a disease (38 articles). For the causation model, the first step, knowledge base, was the most vulnerable step (42 articles). For reported articles, the frequency of false-negative (55 articles) outnumbered the frequency of false-positive (15 articles).


Discussion
In OEM, compared to general medicine, causal misdiagnosis associated with the probability of causation is also important. For making a diagnosis in OEM, a knowledge base about possible ODs and EDs is essential. Because of this reason, the education and training of treating physicians for common ODs and EDs are important. For ODs and EDs, various intentional behaviors of stakeholders should be considered. This scoping review might contribute to the improvement of understanding for misdiagnosis in OEM.
ISSN
1745-6673
Language
English
URI
https://hdl.handle.net/10371/174858
DOI
https://doi.org/10.1186/s12995-021-00325-z
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Graduate School of Public Health (보건대학원)Dept. of Environmental Health (환경보건학과)Journal Papers (저널논문_환경보건학과)
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