Quality Assessment and Management: An Overview of Concordance and Discordance Rates Between Clinical and Autopsy Diagnoses

Autopsy Data to Refine Healthcare Quality: A Fresh Perspective

“…Our previous results have shown that 54.8% of computerized to-mography (CT) scans and 57.9% of magnetic resonance imaging (MRI) studies yielded a previously unsuspected diagnosis. 3 This is in keeping with previous reports that between 20-50% of CT scans and MRI studies do not contribute to patient care. 12 Examples such as these highlight the importance of autopsy data in guiding research and optimizing the use of diagnostic testing.…”

“…20 This has led to a nearly 50% decrease in autopsy rates in the past six decades. 3 It has been reported that for every 10% increase in autopsy rates, there is a 12.4% decrease in major medical errors. 9 Some experts have suggested that if medical autopsy rates were performed on every patient that died in hospital, the rate of major medical errors could be decreased to as low as 4%, 21 illustrating the importance of autopsy in medical education.…”

“…1 Previous studies have predominantly utilized autopsy data to determine discordance rates among pre-and post-mortem diagnoses and to identify pathologies at highest risk of misdiagnosis. Examples of such work that has provided valuable data to guide healthcare policy from around the world include pre-and post-mortem discordance rates of 9.3% in India, 2 12.3% in Canada, 3 17.2% in the USA, 4 18.1% in the Netherlands, 5 19.0% in Greece, 6 25.6% in Spain, 7 28% in Brazil, 8 and 48.4% in Jamaica. 9 Although this area of work has contributed considerably to the practice of diagnostic medicine, it is only beginning to scratch the surface of the potential applications of autopsy data.…”