Quality assurance programme for necropsies

Article Abstract:

In 1950, the autopsy rate in the United States was 60 to 80 percent, but by 1980 it had fallen to 10 percent. A similar decline has taken place in Britain. Autopsy is often considered irrelevant, may be poorly performed by untrained personnel, and the results may not be made available for several months. Physician interest has dwindled, and fear of litigation based on autopsy results has increased. Also, physicians mistakenly believe that the precision of modern techniques of clinical diagnosis have made autopsy superfluous. Finally, autopsies are considered expensive, and the method of payment is not clear, although the cost to the hospital is largely the ''fixed'' cost of staff and physical plant. Autopsies have revealed that the major clinical diagnosis was incorrect in 20 to 30 percent of cases, involving a treatable condition in about half of these, a proportion that has not changed since 1950. The types of undiagnosed disorders have changed over the years, with unusual infections and pulmonary emboli (clots in the lungs) now the most commonly missed diagnoses. Information about the correct diagnosis in the 30 percent of misdiagnosed cases is valuable, and accurate information is vital to statistical analysis of mortality. In order to study the usefulness of autopsies in Britain, 108 autopsies were performed. Errors in diagnosis or treatment were found in 8 percent, complications resulting from treatment in 9 percent, and missed diagnoses were found in 14 percent. There was a high rate of unsuspected diagnoses, and autopsy was considered helpful in over half of all the cases. Monthly conferences presenting short descriptions of two or three major cases would be useful. Not only is this informative for the staff, but it has improved the performance of autopsies because of the likelihood that the case will come up for discussion. (Consumer Summary produced by Reliance Medical Information, Inc.)

Standards, Human dissection

---

Medical students' views on necropsies

Article Abstract:

The number of necropsies (autopsies) being performed has been declining over the last few decades. Several factors that have contributed to the decline in necropsies include bureaucratic and financial considerations, as well as physician work-load. Necropsies provide a valuable tool for revealing diagnoses that were not made prior to death. The use of necropsies in medical student education was formerly more common than it is today. A survey was conducted at the University if Manchester to obtain the opinions of second- and third-year medical students regarding the usefulness of necropsies as a part of medical education. The survey consisted of a self-administered questionnaire on the medical practices of necropsy, whether attendance at necropsies should be required, and personal feelings about necropsies carried out on friends or relatives. Of those responding to the questionnaire, 36 percent felt that necropsy is a useful and necessary procedure in medical practice, 28 percent felt that necropsy has limited use, 17 percent indicated that necropsy is not justified as a routine practice, and 6 percent felt that the number of necropsies should be reduced. When asked if necropsy is a useful and necessary procedure in educating medical students, 42 percent said that it provides a useful teaching experience. Fifty percent felt that attendance at necropsies should be mandatory for medical students, and 40 percent felt that viewing more than one necropsy is important. Sixty-seven percent rejected the idea of having necropsies performed on a family member or relative, while 33 percent said that it would be acceptable. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical students, Surveys, Curricula, Study and teaching, Medical education

---

Autopsies in children: are they still useful?

Article Abstract:

Autopsies can provide additional information on the cause of death in children. Researchers analyzed 297 pediatric deaths at one hospital between 1984 and 1993. An autopsy was done in 36% of the cases over the 10-year period. This autopsy rate remained relatively stable throughout the period. in 34% of the cases, the autopsy provided new information that led to a change in the diagnosis. In seven cases, this information might have led to a change in treatment while the child was alive. Infants were less likely to have an autopsy than older children.

Children

Similar abstracts:

• Abstracts: Quality Measures and Electronic Medical Systems. Building Bridges to Quality. Improving the Quality of Medical Care: Building Bridges Among Professional Pride, Payer Profit, and Patient Satisfaction. (Special Communication)
• Abstracts: Adolescents without health insurance. Court-ordered reimbursement for unproven medical technology: circumventing technology assessment
• Abstracts: National surveillance for neonatal herpes simplex virus infections. Condom use and use-effectiveness in high-risk populations
• Abstracts: Treatment of croup: a critical review. Croup. Update on the immunodeficiency diseases
• Abstracts: Respiratory failure and mechanical ventilation in severe bronchiolitis. High dose pancreatic enzymes in cystic fibrosis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.