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In the past 50 years, the number of autopsies at most U.S. hospitals has dropped drastically. The decline is due in part to a “widespread perception” that new imaging techniques and laboratory tests have improved diagnostic accuracy to the extent that an autopsy is considered obsolete, say researchers from Temple University Hospital in Philadelphia, Pennsylvania. But the researchers claim that autopsies are still relevant and “a valuable tool to evaluate diagnostic accuracy.”
According to the researchers, autopsy studies continue to show that the proportions of clinical misdiagnosis have remained largely unchanged. They also found that autopsies performed over 10 years of 821 adults showed 8% had clinically undiagnosed malignancies—similar to the numbers found in studies done 10 years earlier. Out of 66 cases, 26 revealed undiagnosed malignancies directly related to the primary cause of death. In 16 autopsies, there was no clinical suspicion of malignancy, but the primary cause of death (such as acute bronchopneumonia and gastrointestinal perforation) was directly related to an undiagnosed neoplasm. In 10 cases, there was clinical suspicion of malignancy based on history, radiologic studies, and laboratory tests but without definite tissue diagnosis.
The researchers note that some studies have suggested a link between short hospital stays and missed diagnoses. But in the current study, length of stay had no bearing on a patient’s having an unsuspected malignancy. “Ironically,” the cases with no clinical suspicion involved longer hospital stays. In at least 5 cases the hospital stay was for more than 5 days. Moreover, CT scans of the thorax/abdomen raised no suspicion of cancer.
The researchers say their findings make a “strong case for a vigorous hospital autopsy program,” and for using autopsy data to improve performance in clinical, radiologic, and laboratory services. Their study “reiterates the value of the hospital autopsy as an auditing tool for diagnostic accuracy.”
Source: Parajuli S, Aneja A, Mukherjee A. Hum Pathol. 2016; 48:32-36.
doi: 10.1016/j.humpath.2015.09.040.
In the past 50 years, the number of autopsies at most U.S. hospitals has dropped drastically. The decline is due in part to a “widespread perception” that new imaging techniques and laboratory tests have improved diagnostic accuracy to the extent that an autopsy is considered obsolete, say researchers from Temple University Hospital in Philadelphia, Pennsylvania. But the researchers claim that autopsies are still relevant and “a valuable tool to evaluate diagnostic accuracy.”
According to the researchers, autopsy studies continue to show that the proportions of clinical misdiagnosis have remained largely unchanged. They also found that autopsies performed over 10 years of 821 adults showed 8% had clinically undiagnosed malignancies—similar to the numbers found in studies done 10 years earlier. Out of 66 cases, 26 revealed undiagnosed malignancies directly related to the primary cause of death. In 16 autopsies, there was no clinical suspicion of malignancy, but the primary cause of death (such as acute bronchopneumonia and gastrointestinal perforation) was directly related to an undiagnosed neoplasm. In 10 cases, there was clinical suspicion of malignancy based on history, radiologic studies, and laboratory tests but without definite tissue diagnosis.
The researchers note that some studies have suggested a link between short hospital stays and missed diagnoses. But in the current study, length of stay had no bearing on a patient’s having an unsuspected malignancy. “Ironically,” the cases with no clinical suspicion involved longer hospital stays. In at least 5 cases the hospital stay was for more than 5 days. Moreover, CT scans of the thorax/abdomen raised no suspicion of cancer.
The researchers say their findings make a “strong case for a vigorous hospital autopsy program,” and for using autopsy data to improve performance in clinical, radiologic, and laboratory services. Their study “reiterates the value of the hospital autopsy as an auditing tool for diagnostic accuracy.”
Source: Parajuli S, Aneja A, Mukherjee A. Hum Pathol. 2016; 48:32-36.
doi: 10.1016/j.humpath.2015.09.040.
In the past 50 years, the number of autopsies at most U.S. hospitals has dropped drastically. The decline is due in part to a “widespread perception” that new imaging techniques and laboratory tests have improved diagnostic accuracy to the extent that an autopsy is considered obsolete, say researchers from Temple University Hospital in Philadelphia, Pennsylvania. But the researchers claim that autopsies are still relevant and “a valuable tool to evaluate diagnostic accuracy.”
According to the researchers, autopsy studies continue to show that the proportions of clinical misdiagnosis have remained largely unchanged. They also found that autopsies performed over 10 years of 821 adults showed 8% had clinically undiagnosed malignancies—similar to the numbers found in studies done 10 years earlier. Out of 66 cases, 26 revealed undiagnosed malignancies directly related to the primary cause of death. In 16 autopsies, there was no clinical suspicion of malignancy, but the primary cause of death (such as acute bronchopneumonia and gastrointestinal perforation) was directly related to an undiagnosed neoplasm. In 10 cases, there was clinical suspicion of malignancy based on history, radiologic studies, and laboratory tests but without definite tissue diagnosis.
The researchers note that some studies have suggested a link between short hospital stays and missed diagnoses. But in the current study, length of stay had no bearing on a patient’s having an unsuspected malignancy. “Ironically,” the cases with no clinical suspicion involved longer hospital stays. In at least 5 cases the hospital stay was for more than 5 days. Moreover, CT scans of the thorax/abdomen raised no suspicion of cancer.
The researchers say their findings make a “strong case for a vigorous hospital autopsy program,” and for using autopsy data to improve performance in clinical, radiologic, and laboratory services. Their study “reiterates the value of the hospital autopsy as an auditing tool for diagnostic accuracy.”
Source: Parajuli S, Aneja A, Mukherjee A. Hum Pathol. 2016; 48:32-36.
doi: 10.1016/j.humpath.2015.09.040.