Table 4.

Patient perceived importance of reasons of misdiagnosis and information sources of hospitals giving the correct diagnosis.

Reasons	Rank of importance of reasons (n=447)
	Most important reason		2nd most important reason		3rd most important reason
	N	%	N	%	N	%
Issues ascribed to doctors and their communication with patients1	324	72.5	74	16.6	61	13.6
Issues ascribed to patients2	62	13.9	179	40.1	92	20.5
Issues ascribed to medical science and diagnostic test3	37	8.3	129	28.8	176	39.4
Issues ascribed to hospitals4	17	3.8	43	9.6	84	18.8
Financial issues5	7	1.6	22	4.9	32	7.2
Sources of information	Rank of importance of information source of the hospitals giving the correct diagnosis (n=447)
	Primary source		2nd source		3rd source
	N6	%	N	%	N	%
Selecting it based on the hospital’s reputation in general	193	43.2	21	4.7	3	0.7
Recommended by family members/friends	94	21.0	18	4.0	6	1.3
Recommended by doctors	53	11.9	18	4.0	4	0.9
Internet search	41	9.2	32	7.2	7	1.6
Patient group	24	5.4	9	2.0	6	1.3

¹Issues of doctors and their communication with patients included ‘insufficient doctors in this specialty’, ‘low awareness of this disease’, ‘limited knowledge of this disease which led to misjudgment’, ‘poor communication between patients and doctors’ and ‘doctors do not have enough time to ask details of the patients’ condition and background’.

²Issues of patients included ‘low frequency of medical consultation’, ‘lack of valid information source to know about hospital/doctors specialized in this kind of disease’, ‘reluctance to share some information with doctors’, ‘lack of knowledge to one’s own conditions’ and ‘prejudice and discrimination against patients with rare diseases’.

³Issues of medical science and diagnostic tests included ‘substantial knowledge gaps between different specialties’, ‘limited communications among specialties’, ‘limited methods/equipment for diagnosis’ and ‘sensitivity and accuracy of diagnostic test not ideal’.

⁴Issues of hospital included ‘no screening tool provided by the hospitals for this disease’ and ‘difficulties in getting reservation for an expert’.

⁵Financial issues included ‘high charge of diagnostic test’ and ‘need to travel around other cities to get diagnosed’.

⁶The numbers of patients in the column of primary source of information for the hospital do not add up to 447 as the responses of 42 patients were missing values.