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Autopsies Very Valuable, Seldom Performed

Reuters news service reported on January 21, 2003 that a study commissioned by the College of American Pathologists found that autopsies, while seldom performed, can yield important information.

The U.S. Agency for Healthcare Research and Quality did the study, which was a literature review of more than 50 studies of autopsies over a 40 year period.

The study found that the cause of death in U.S. hospitals in the year 2000 may have been incorrectly diagnosed between 8% and 23% of the time. 5% of autopsies found complications of medical care that had not been suspected before the autopsy. In up to 8% of all deaths, a “diagnostic discrepancy” may have harmed the patient.

In 1994, the latest year data is available, autopsied were done in less than 6% of deaths that were not investigated for forensic purposes. In the 1960s, autopsy rates peaked at a high of 50%. Concerns about who pays for the autopsies, changing beliefs and other factors have led to the decline in the number performed.

The authors conclude that, “Clinical diagnoses, whether obtained from death certificates or hospital discharge data, contain major inaccuracies compared with diagnoses generated from postmortem findings.”

Commentary: In other words, doctors blow the diagnosis nearly a quarter of the time and the authors feel that doing more autopsies would help them be better doctors and diagnosticians. While we agree, we don’t anticipate this happening. More autopsies would lead to more doctors finding out that they have made a mistake in diagnosis a quarter of the time. Not to mention that they may well have harmed the patient 8% of the time. We’re not surprised that hospitals and doctors are reluctant to do more autopsies.

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