The analysis of misdiagnosed rheumatism cases reported in Chinese journal in 16 years: a retro-spective study

Objective To investigate the causes of misdiagnosis related to rheumatism diseasecases. Methods A search was performed in database WanFang to identify the misdiagnosed clinical cases reports which were published in Chinese Journal and a retrospective analysis was conducted. All data were analyzed by chi-square test and Fisher′s exact test. Results We screened 705 citations and identified 215 articles on the rheumatic diseases, finally, 187 reports and 195 cases in total with definite diagnosis were included, accounting for 25.5% of the total number of misdiagnosed cases. Primary vasculitis (72 cases), rheumatoid arthritis (25 cases), spondyloarthropathy (17 cases), polymyositis (14 cases), systemic lupus erythematosus (13 cases) and Sjogren′s syndrome (SS) (12 cases) were amongst the top misdiagnosed rheumatic diseases. There was no difference between 1998-2006 and 2007-2015 in the overall misdiagnosis cases. Single disease comparison, polymyositis, spondyloarthropathy and IgG4 related disease were increased (P=0.002; P=0.034; P=0.060; respectively), while polymyositis was delayed (P=0.002). Rheumatism misdiagnosed cases reported mainly came from tertiary hospitals and the department of rheumatology. Conclusion Misdiagnosed rheumatism are common in clinic. Strengthen the physicians′ continuous education, the validity of clinical thinking mode and rational use of diagnostic criteria are important to make correct diagnosis. Key words: Rheumatic disease; Dignostic errors; Retrospective studies