Correlation between clinical and autopsy diagnosis at the University of the West Indies

ABSTRACT

Autopsies help in the understanding of the disease process, check the accuracy of clinical diagnosis and provide reliable data for the epidemiologist. Although the number of comparative autopsy studies is very limited, the rate of discrepancy between clinical and autopsy ranges from 4 to 68 per cent. To determine the discrepancy between clinical and autopsy diagnoses, and to find out the major disease groups where the errors are most frequently made, a preliminary study was undertaken. One hundred and seventy-eight consecutive autopsies at the University Hospital of the West Indies over an eighteen month period were analysed and the results were compared with similar studies from other institutions. The overall rate of major discrepancy was 16 percent. The most frequently missed diagnoses were thromboembolism (40 percent), followed by malignancies (25 percent) and infection (22 percent). Sickle-cell disease made a special group. In the majority of the sicklers there was no anatomical cause of death, neither was there a clinical diagnosis as to the cause of death. The overall discrepancy rate and the rate of error in major groups in this study is lower than in other similar studies (AU)