title: Comparison of clinical causes of death with autopsy diagnosis using discrepency classification.
abstract: OBJECTIVE
  To determine the usefulness of autopsy findings in the quality improvement of patients care.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  Departments of Pathology and Medicine, Combined Military Hospital (CMH) Kharian, a tertiary care hospital, from January 2001 to December 2003.
  
  
  METHODS
  The clinical and necropsy findings of all the cases, who died in hospital and had undergone autopsy examination at CMH, Kharian, from January 2001 to December 2003, were retrieved from record of clinical case sheet data and autopsy record of the hospital. The two were analyzed and compared according to the discrepancy classification. The exclusion and inclusion criteria, the international classification of disease (ICD) to code deaths, the global burden of disease (GBD) system to classify and group diseases, and the Goldman discrepancy classification to compare clinical and autopsy diagnosis and classify the discrepancies, were used as described.
  
  
  RESULTS
  The death rate varied from 0.94% to 1.29% and autopsy rate from 4.69% to 10.10% annually between January 2001 and December 2003. The number of cases classified according to GBD system was 3 (5%) in Group 1, 26 (43.33 %) in Group 2 and 31 (51.66 %) in Group 3. The discrepancy classes included 9 (15 %) class I major discrepancies and 3 (5 %) class II major discrepancies. Non-discrepant diagnosis was seen in 37 cases (61.66 %) and 11 cases (18.32 %) were non-classifiable.
  
  
  CONCLUSIONS
  This study showed the usefulness of autopsy findings in the quality improvement of the diagnosis and management of the disease by showing only a minority of cases with discrepant diagnosis of the cause of death.
authors.affiliation: Department of Pathology, CMH, Kharian. kisapzai@hotmail.com
authors.forename: Khalil
authors.initials: K
authors.lastname: Ullah
authors.forename: Wasim
authors.initials: W
authors.lastname: Alamgir
mesh_terms: D001344:Autopsy; D002423:Cause of Death; D003933:Diagnosis; D006801:Humans