By Jasmine Evans
A new study from Johns Hopkins University shows that emergency-room physicians are more likely to misdiagnose Black stroke patients. In fact, Blacks and patients from other underrepresented groups are 30 percent more likely than whites to be misdiagnosed.
Researchers looked at emergency-room visit records across nine states and found that almost 14 percent of stroke admissions were misdiagnosed. The odds for misdiagnosis were higher for underrepresented groups, women and young people.
Stroke ranks among the leading causes of death in the United States, according to the Centers for Disease Control. About 800,000 Americans suffer a stroke every year, and almost 130,000 Americans die as a result of a stroke—that’s an average of one every four minutes, or one out of every 19 American deaths.
Blacks are nearly twice as likely as whites to suffer a stroke, and are also more likely to die as a result.
According to The Internet Stroke Center, stroke is also the leading cause of serious, long-term disability. When patients are misdiagnosed, the risk of death and disability increase significantly.
Traditional stroke symptoms include paralysis on one side of the body, trouble speaking and balance problems, according to Kaiser Permanente (No. 4 in the DiversityInc Top 50). Emergency-room doctors rarely miss these symptoms, but the study found that with nontraditional symptoms such as headaches and dizziness, the odds of misdiagnosis increase 43-fold.
Doctors currently diagnose strokes by focusing on age and vascular risk factors to determine the odds, meaning older male patients are less likely to be misdiagnosed. The research team from Johns Hopkins concluded that doctors need to find clinical symptoms that reliably identify strokes rather than depend on patient demographics. Solutions to this problem will most likely require new technology, scientific discoveries and improved training in diagnostics for doctors.
However, lapses in the diagnosis method do not explain why so many members of underrepresented groups are misdiagnosed. Blacks, specifically, are already more likely to have a stroke because of the prevalence of obesity in the Black community. So there must be a reason why many doctors aren’t considering stroke as a possibility when treating Blacks for stroke-related symptoms. Doctors may be unintentionally relying on an internal bias that causes them to believe the symptoms are due to another ailment rather than a stroke. Or, perhaps, members of underrepresented groups are more prone to nontraditional stroke symptoms. More research is needed into this issue in order to prevent future deaths and disabilities.
And the Hopkins researchers note that there is very little funding to find a solution to this issue. So patients have to advocate for themselves not only in the emergency room but also with Congressional representatives. The hope is that in the near future, improved technological and other diagnostic tools will reduce the number of misdiagnoses.
