When nobody seems to find the right diagnosis
When it comes to medicine, time is paramount since early diagnosis plays a decisive role in the successful treatment of many diseases. But people with chronic forms of pain often wait months to years for a proper diagnosis and thus for adequate treatment. Why is that – and how could we improve it?
Late diagnosis often leads to serious consequences
Diseases such as diabetes or depression frequently remain undetected for up to 7 years. Women with endometriosis even suffer from debilitating pain for up to 11 years until the diagnosis becomes certain. In most cases, late diagnosis means physical and psychological suffering for the patient. Chronic pain, a lack of understanding from their social environment and in the worst case, perhaps even doubts of the physicians treating them about the legitimacy of the perceived symptoms. All these factors are a massive burden for chronically affected people who are just waiting to be diagnosed.
For many diseases, a late diagnosis and the resulting delay of therapy have lasting negative consequences, such as an unfavorable progression of the disease or other complications. One example is type 2 diabetes: If diabetics are not aware of their disease, the risk of suffering from a diabetic retinal disease with permanent blindness is considerably higher. Irreparable kidney damage can also occur, which at some point can only be treated through dialysis and by transplanting a new kidney. Severe diseases result in a poorer prognosis for survival. Late diagnosis can thus not only reduce the quality of life but also cost a lifetime.
Besides the consequences for patients, inadequate diagnoses also result in more hospital admissions, increased demand for therapies and medication, and thus significantly higher costs for the healthcare system.
Not everyone has equal opportunities
By global standards, the Austrian healthcare system is one of the best and most comprehensive. The country-specific health report for all EU members, including Norway and Iceland, which is conducted every 2 years by the European Commission and the OECD, acknowledges Austria’s overall positive rating. Quality and access to healthcare are good in general but hospitals play a disproportionate role in providing healthcare services. Austria is also among the countries with the lowest share of people complaining about unmet medical needs. However, a wave of doctor retirements expected in the near future on the one hand, and a stagnating number of doctors with statutory health insurance (SHI) contracts on the other hand, may result in reduced availability and access to services.
At the same time, the number of doctors without SHI contracts is increasing, especially in urban areas. This can raise financial barriers to access and have a negative impact on equity of care. The place of living also plays an important role, especially in rural areas. So does the socio-economic status, i.e. education and income.
However, the fact that it often takes years until a diagnosis is made is not only due to socio-demographic reasons. The more knowledge is generated by research, the more difficult it becomes for doctors to keep up to date with the latest findings. Especially for general practitioners this is almost impossible as time resources are often simply lacking. Since the medical fields are also becoming more and more specialized, doctors often have selective knowledge but fail to see the bigger picture. Therefore, it is all the more important that technologies such as AI are also used by practitioners to support diagnostics.
Speeding up diagnosis with AI
In order to shorten the time to diagnosis, a number of screening methods are now employed in the form of questionnaires, examinations of samples or imaging procedures. They are designed to identify those who show abnormalities or who show a higher risk due to certain factors. However, screenings do not serve as diagnostic tools and usually require direct contact between medical personnel and those seeking help. Although screening methods are valuable and important tools for diagnosis, they are not a panacea.
An effective and patient-centered way of augmenting this is through software-based decision support systems that are powered by AI and are easily accessible, for example via mobile apps. These systems could be used prior to face-to-face appointments with doctors and provide preliminary assessments and pre-qualification. In doing so, patient flows could be better managed and the burden on the healthcare system relieved. Patients would thus be able to become active and self-determined partners in the diagnostic process.
The use of modern technologies could not only shorten the time to diagnosis but also improve patient satisfaction and treatment success. Shorter waiting times ensure better outcomes, faster recovery and fewer complications. It also significantly reduces costs, as the automation of various processes saves time and money.