Delayed Diagnosis Linked to Persistent Lyme Disease

Lyme disease is the most common vector-borne disease in the United States. Diagnostic errors are believed to be common. Errors stemming from delayed or inaccurate diagnosis are generally the number one cause of serious harms among medical errors. The Agency for Healthcare Research and Quality has made reduction of diagnostic errors one of its three strategic priorities.

The National Academy of Medicine (NAM) has developed a schematic to identify points in the medical care system where diagnostic errors occur. It defines diagnostic medical error as “the failure to (a) establish an accurate and timely explanation of the patient's health problem(s) or (b) communicate that explanation to the patient." NAM looks at errors that occur when the patient first encounters the healthcare system, when clinical history is taken, during physical exam, and when diagnostic testing is being conducted. They then look at the consequences and costs of the diagnostic errors.

This study analyzes patient responses from the MyLymeData Patient Registry using the NAM schematic to identify points of diagnostic errors in persistent Lyme disease.

Most patients with persistent Lyme disease are not diagnosed until six or more months after symptom onset. Early diagnosis and treatment of acute Lyme disease usually prevents the progression to persistent Lyme disease. Diagnostic barriers include: using inaccurate geographic risk maps, failing to consider the most common early manifestations of the disease, and over reliance on imperfect lab tests. Remedying these identified diagnostic errors may significantly improve patient outcomes by providing patients with early diagnosis and treatment, which is associated with higher treatment success.