The importance of autopsies despite the declining number amidst the COVID-19 pandemic

Bhatt, Monika; MovaseghiGargari, Mani; Chand, Momal

doi:10.4322/acr.2021.371

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…A decline of 12% in hospital investigations was observed in Australia between 1992 and 2003 [10]. This trend was also observed in other countries [11][12][13][14]. Also, at the Regional Hospital of Rio Blanco, situated in the Mexican state of Veracruz, the pathology department identified a considerable reduction in autopsies performed in recent years.…”

Section: Introductionmentioning

confidence: 54%

Medical Opinions Analysis about the Decrease of Autopsies Using Emerging Pattern Mining

Machorro-Cano,

Ríos-Méndez,

Palet-Guzmán

et al. 2023

Data

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An autopsy is a widely recognized procedure to guarantee ongoing enhancements in medicine. It finds extensive application in legal, scientific, medical, and research domains. However, declining autopsy rates in hospitals constitute a worldwide concern. For example, the Regional Hospital of Rio Blanco in Veracruz, Mexico, has substantially reduced the number of autopsies at hospitals in recent years. Since there are no documented historical records of a decrease in the frequency of autopsy cases, it is crucial to establish a methodological framework to substantiate any actual trends in the data. Emerging pattern mining (EPM) allows for finding differences between classes or data sets because it builds a descriptive data model concerning some given remarkable property. Data set description has become a significant application area in various contexts in recent years. In this research study, various EPM (emerging pattern mining) algorithms were used to extract emergent patterns from a data set collected based on medical experts’ perspectives on reducing hospital autopsies. Notably, the top-performing EPM algorithms were iEPMiner, LCMine, SJEP-C, Top-k minimal SJEPs, and Tree-based JEP-C. Among these, iEPMiner and LCMine demonstrated faster performance and produced superior emergent patterns when considering metrics such as Confidence, Weighted Relative Accuracy Criteria (WRACC), False Positive Rate (FPR), and True Positive Rate (TPR).

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Section: Introductionmentioning

confidence: 54%

Medical Opinions Analysis about the Decrease of Autopsies Using Emerging Pattern Mining

Machorro-Cano,

Ríos-Méndez,

Palet-Guzmán

et al. 2023

Data

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“…A virtopsy can determine the cause of death in situations where traditional autopsies are not possible or refused by the family (32). In details, such situations include cultural or religious beliefs that prohibit invasive procedures (11)(12)(13), suspected infectious diseases that could endanger medical personnel (7)(8)(9), and mass/natural disasters that render traditional autopsies impractical (35,36). It allows for determining the cause of death without compromising the safety of medical personnel or disturbing the body.…”

Section: What Is Virtopsy and How Does It Work Technically?mentioning

confidence: 99%

“…In Indonesia, where opposition to autopsies is prevalent, the autopsy rate has drastically decreased from 10.4% in 2011 to 6.9% in 2012, 4.2% in 2013, 5% in 2014, and 5.2% in 2015 (6). Autopsy rates have declined due to increased infection risk for clinicians handling deceased with infectious disease (e.g., HIV/AIDS) and during the COVID-19 pandemic, particularly in developing countries (7)(8)(9). COVID-19 patients' known cause of death led many hospitals to not perform autopsies, worsening already low rates and even making it harder for pathology and forensic residents to meet requirements (7).…”

Section: Introductionmentioning

confidence: 99%

“…Autopsy rates have declined due to increased infection risk for clinicians handling deceased with infectious disease (e.g., HIV/AIDS) and during the COVID-19 pandemic, particularly in developing countries (7)(8)(9). COVID-19 patients' known cause of death led many hospitals to not perform autopsies, worsening already low rates and even making it harder for pathology and forensic residents to meet requirements (7). A study conducted in Rhode Island, USA, revealed that despite an increase in autopsy cases during the pandemic, the overall autopsy rate, which was already low, did not change significantly.…”

Section: Introductionmentioning

confidence: 99%

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Virtopsy as a Breakthrough in Non-Invasive Autopsy: Its Principles and Potential of Application in Developing Countries During the Covid-19 Pandemic

Habiburrahman,

Wardoyo,

Yudhistira

2023

JUMMEC

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Autopsy practice is often limited due to the risk of infection transmission and family objections. As an alternative, virtual autopsy (virtopsy) is proposed, which uses minimally invasive radiology techniques such as postmortem CT scan (PM-CT) and PM-MRI. However, there is a scarcity of literature comprehensively summarizing this topic. Therefore, this review article discusses the advantages and limitations of virtopsy in developing countries during the COVID-19 pandemic, along with ethical issues and a proposed algorithm for postmortem imaging. Virtopsy improves the sensitivity (93%) and specificity (83%) of diagnoses and offers several advantages, such as faster identification, good foreign body detection, three-dimensional reconstruction, and non-invasiveness. Limitations include difficulty in determining infection status and assessing internal organ characteristics, operator dependence, insufficient legal basis, and high costs. During the COVID-19 pandemic, this article compiles twenty-one studies from 2020 to 2022 that used virtopsy to investigate 191 cases of COVID-19 infection resulting in death. The studies were conducted in various countries, with only two developing countries [Brazil (n = 3) and India (n = 1)] reported to have used it. Most of the studies used PM-CT, while others used postmortem ultrasound, PM-MRI, and PM chest X-ray. Virtopsies were mostly performed within 24 hours. The age range of the deceased individuals investigated using virtopsy was between 11 and 99 years old, with males being predominant. Virtopsy was mostly used for triage or screening for conventional autopsy (CA) as well as adjuvant/complement to CA. In summary, virtopsy has potential benefits for developing countries during and after the COVID-19 pandemic, making it a valuable investment despite its limitations.

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“…Applying clinical biomarkers in a post mortem setting does not violate the medicolegal requirements for death investigations. Nevertheless, instead of limiting the contents of the death investigation toolbox, biomarkers could be used to decrease the rate of clinicalautopsy discrepancies and to reduce post mortem healthcare inequalities [12,123,124].…”

Section: Applying Clinical Biomarkers In a Post Mortem Settingmentioning

confidence: 99%

Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers

Šoša

2023

Forensic Sciences

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Many tools of clinical medicine, such as clinical chemistry and diagnostic imaging, are prioritized for clinical diagnosis over post mortem diagnosis. Indeed, it is reasonable that the assessment of a patient’s functional status should take priority over the post mortem, cross-sectional use of diagnostic tests and laboratory equipment. In addition, these tools are sometimes expensive, and their use does not always have a reasonable cost–benefit ratio. However, some post mortem observations, such as inflammation, pulmonary edema, or infiltration and cerebral swelling, cannot be explained without using immunohistochemical markers for post mortem diagnosis. Introducing blood-based biomarkers into post mortem care could significantly reduce the rates of inconclusive post mortems and discrepancies in autopsy findings and clinical diagnoses. This is particularly relevant in relation to vascular pathology, considering the significant burden that vascular diseases represent for overall mortality. Expanding traditional autopsies with blood-based (circulating) biomarkers to avoid invasive post mortem examination would have cultural, religious, and potentially economic advantages. All of the target molecules were discussed in the context of the processes they up-regulate or down-regulate, which turned out to be the final cause of death. Ultimately, it is evident that further studies are needed to provide concrete validation for using a combination of markers for each case to reach a post mortem diagnosis with or without clinical records.

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The importance of autopsies despite the declining number amidst the COVID-19 pandemic

Cited by 5 publications

References 8 publications

Medical Opinions Analysis about the Decrease of Autopsies Using Emerging Pattern Mining

Medical Opinions Analysis about the Decrease of Autopsies Using Emerging Pattern Mining

Virtopsy as a Breakthrough in Non-Invasive Autopsy: Its Principles and Potential of Application in Developing Countries During the Covid-19 Pandemic

Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers

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