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(Chest. 1972;62:388-393.)
© 1972 American College of Chest Physicians

Factors Contributing to the Incorrect Diagnosis of Pulmonary Embolic Disease

Baruch Modan M.D.1; Ezra Sharon M.D.1; and Navah Jelin B.A.1

1 Department of Clinical Epidemiology, Tel Hashomer Government Hospital, Israel

A study of 2,107 consecutive patients on whom an autopsy had been performed in one major medical center during a four-year period revealed 545 who had had either a clinical or pathologic diagnosis or both of a pulmonary embolus. The frequency of a false negative diagnosis was 66.6 percent, and the frequency of false positives of all cases with a clinical diagnosis of pulmonary embolus was 61.9 percent. The frequencies were unrelated to age, sex, or ethnic origin, but were slightly lower among patients who died on the surgical ward. A variety of clinical factors and in particular the underlying disorder, played a role in both false positive and false negative diagnoses. Lack of ECG and chest x-ray examinations increased the false negative rate, but had no effect on the false positive rate. The cases with false negative diagnoses differed from those with correct diagnoses in the location of the embolus and in a lower frequency as cause of death.




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