Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South Africa
Background. The anatomical pathology autopsy serves several purposes, notably as a quality management tool for evaluation of accuracy in clinical diagnosis. Despite its value, for various reasons there has been an international decline in autopsies conducted. In the modern medical era, with all its...
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| Format: | Article |
| Language: | English |
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South African Medical Association
2022-11-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/401 |
| _version_ | 1797334479542419456 |
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| author | DM Joubert SH Rossouw C Solomon PWA Meyer |
| author_facet | DM Joubert SH Rossouw C Solomon PWA Meyer |
| author_sort | DM Joubert |
| collection | DOAJ |
| description |
Background. The anatomical pathology autopsy serves several purposes, notably as a quality management tool for evaluation of accuracy in clinical diagnosis. Despite its value, for various reasons there has been an international decline in autopsies conducted. In the modern medical era, with all its advances in technology, diagnostic techniques and interventions, there is still a high discrepancy between clinical diagnoses and postmortem findings.
Objectives. To establish the discrepancies between clinical diagnoses and postmortem findings in anatomical pathology autopsies.
Methods. A retrospective, descriptive study was conducted over the 4-year-period 2014 - 2017. The clinical diagnoses and postmortem
findings of cases referred to the Department of Anatomical Pathology at the University of Pretoria, South Africa, were evaluated and
compared using the modified Goldman criteria.
Results. A total of 288 cases qualified for the study and were evaluated. The gender distribution was 155 (53.8%) male and 133 (48.2%)
female, with the majority of cases in the age group 19 - 60 years (mean 36.4). The majority of the cases were referred by internal medicine, followed by paediatrics. The most common cause of death in major missed diagnoses was pulmonary conditions. Of the cases, 115 (39.3%) had a major discrepancy and 62 (21.5%) a minor discrepancy.
Conclusion. This study showed that there is still a high discrepancy between clinical diagnoses and postmortem findings, similar to studies conducted globally. The current COVID-19 pandemic may be a driver for revival of the anatomical pathology autopsy, and future studies are recommended to evaluate whether the decline can be reversed.
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| first_indexed | 2024-03-08T08:21:21Z |
| format | Article |
| id | doaj.art-81c6c50482294f21affdfba782a39459 |
| institution | Directory Open Access Journal |
| issn | 0256-9574 2078-5135 |
| language | English |
| last_indexed | 2024-03-08T08:21:21Z |
| publishDate | 2022-11-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj.art-81c6c50482294f21affdfba782a394592024-02-02T05:55:51ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352022-11-011121110.7196/SAMJ.2022.v112i11.15825Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South AfricaDM Joubert0SH Rossouw1C Solomon2PWA Meyer3 Department of Forensic Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa Department of Forensic Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, South AfricaDepartment of Anatomical Pathology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa; Department of Anatomical Pathology, National Health Laboratory Service, Pretoria, South Africa Department of Immunology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa Background. The anatomical pathology autopsy serves several purposes, notably as a quality management tool for evaluation of accuracy in clinical diagnosis. Despite its value, for various reasons there has been an international decline in autopsies conducted. In the modern medical era, with all its advances in technology, diagnostic techniques and interventions, there is still a high discrepancy between clinical diagnoses and postmortem findings. Objectives. To establish the discrepancies between clinical diagnoses and postmortem findings in anatomical pathology autopsies. Methods. A retrospective, descriptive study was conducted over the 4-year-period 2014 - 2017. The clinical diagnoses and postmortem findings of cases referred to the Department of Anatomical Pathology at the University of Pretoria, South Africa, were evaluated and compared using the modified Goldman criteria. Results. A total of 288 cases qualified for the study and were evaluated. The gender distribution was 155 (53.8%) male and 133 (48.2%) female, with the majority of cases in the age group 19 - 60 years (mean 36.4). The majority of the cases were referred by internal medicine, followed by paediatrics. The most common cause of death in major missed diagnoses was pulmonary conditions. Of the cases, 115 (39.3%) had a major discrepancy and 62 (21.5%) a minor discrepancy. Conclusion. This study showed that there is still a high discrepancy between clinical diagnoses and postmortem findings, similar to studies conducted globally. The current COVID-19 pandemic may be a driver for revival of the anatomical pathology autopsy, and future studies are recommended to evaluate whether the decline can be reversed. https://samajournals.co.za/index.php/samj/article/view/401Geneticautopsy |
| spellingShingle | DM Joubert SH Rossouw C Solomon PWA Meyer Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South Africa South African Medical Journal Genetic autopsy |
| title | Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South Africa |
| title_full | Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South Africa |
| title_fullStr | Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South Africa |
| title_full_unstemmed | Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South Africa |
| title_short | Discrepancies between clinical diagnoses and autopsy findings: A comparative study conducted in South Africa |
| title_sort | discrepancies between clinical diagnoses and autopsy findings a comparative study conducted in south africa |
| topic | Genetic autopsy |
| url | https://samajournals.co.za/index.php/samj/article/view/401 |
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