title: An analysis of 60 years of autopsy data from Zhejiang university in Hangzhou, China.
abstract: BACKGROUND
  The autopsy rate gradually decreased during 1950-1999, and increased during the most recent decade (2000-2009). The diagnostic inaccuracy rate was continuously high during the 60 years.
  
  
  OBJECTIVE
  To investigate disagreement between the pathological and clinical diagnosis during 60 years (1950-2009).
  
  
  METHODS
  A 60-year retrospective study was carried out on the 4140 autopsy cases performed in Zhejiang University School of Medicine.
  
  
  RESULTS
  The highest number of cases was 1037 during 1960-1969, while the lowest was 102 during 1990-1999. During the 1999-2009 period, 978 cases were completed, which ranked second within the 60 years. The total clinical misdiagnosis rate was 46.38%, while the highest was 73.82% in 2000-2009. During the 60 years, the diseases associated with highest diagnostic inaccuracy rates were circulatory diseases (76.97%), cancer (60.99%), and brain diseases (54.48%). The invasive fungal infection rate was 1.84% of the 4140 cases, and the diagnostic inaccuracy rate for this condition reached as high as 86.10%. In the autopsied disease spectrum over the 60 years, the most common diseases were respiratory (1349, 32.58%), circulatory (495, 11.96%), and brain diseases (424, 10.24%).
  
  
  CONCLUSIONS
  Although the number of autopsies decreased from 1950 to 1999, it increased from 2000 to 2009, while the discordance rate between clinical and autopsy diagnosis remained high throughout.
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China; Department of Neuroscience, Zhejiang University School of Medicine, Hangzhou, China; China Brain Bank, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Keqing
authors.initials: K
authors.lastname: Zhu
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Haijia
authors.initials: H
authors.lastname: Feng
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Yinhan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Zhengrong
authors.initials: Z
authors.lastname: Mao
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Liqing
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Minche
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Qiunian
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Suojiang
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000706:statistics & numerical data*; D001927:Brain Diseases / Q000175:diagnosis* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002681:China; D003933:Diagnosis; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies