[Correlation of the autopsy with the clinical diagnosis].
Since Morgagni's times (1761) the purpose of autopsy is correlation of the clinical diagnosis and therapy, assessment of the cause of death, description and the diagnosis of unknown diseases, teaching and later collection of epidemiological data. The clinical and pathological correlation involves assessment of the sensitivity and specificity of the clinical diagnosis (autoptic findings are conceived as the reference value), and assessment of the frequency and seriousness of diagnostic errors. The importance of autopsies is apparent from the fact that the sensitivity and specificity of clinical diagnoses of some common diseases improved between 1930 and 1977, in others it remained the same, in others it deteriorated. Deterioration pertains in particular to the diagnosis of infectious diseases, some types of malignant tumours and diseases of the circulation, regardless of technological advances of diagnostic methods. The rate of errors in the diagnosis of basic diseases leading to death and immediate causes of death where knowledge of the autoptic diagnosis would probably changes the therapy and prognosis varies round 10%, the frequency of similar errors, where this knowledge would not alter the above procedures is twice or three times as high. If for the interpretation of autoptic results the "epidemiological" principle is used, the different incidence of common diseases in the population, as compared with official statistics becomes apparent, the official statistics being based on the collection of data from the death certificates. The latter data are biased by a high rate of diagnostic errors and selection phenomena.
Oddĕlení patologie fakultní Thomayerovy nemocnice, Praha.
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Koukolík
D001344:Autopsy; D003951:Diagnostic Errors; D006801:Humans; D012680:Sensitivity and Specificity
Autoptická korelace klinické diagnostiky.