Americans know that doctors make mistakes and that misdiagnoses can happen. But a new study reveals some shocking numbers on just how many patients are affected.

According to a study published in the journal BMJ Quality & Safety, 12 million adults, that’s 1 out of 20 patients, are misdiagnosed. Researchers also note that in half those cases, there is potential for severe harm.

Lead author Dr. Hardeep Singh, of the Baylor College of Medicine and the Michael E. DeBakey Veterans Affairs Medical Center in Houston, co-authored a similar study in 2012.That one was published in JAMA Internal Medicine and found that some of the most common reasons for misdiagnosis include problems with ordering diagnostic tests; failure by the patient to provide an accurate medical history; and errors made by a doctor in interpreting test results.

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