Assessing the accuracy of death records and pre-mortem clinical diagnoses in children diagnosed with brain tumors: A retrospective chart review of children in British Columbia, Canada.
The advantages of autopsy have been demonstrated in pediatric oncology; however, it is unknown to what extent the utility of autopsy is in deceased children diagnosed with a pediatric brain tumor (PBT). The purpose of this study was to describe the frequency of autopsy, prevalence of clinical discrepancies, and accuracy of cancer registry death records for deceased children diagnosed with a PBT in British Columbia, Canada. A retrospective chart review was performed of medical records and autopsy reports of pediatric patients diagnosed with a PBT that died between 1982 and 2012 in British Columbia. Clinical discrepancies between pre- and post-mortem findings were classified based on a modified classification system of the Goldman Criteria. The overall autopsy rate was 15.5% (32 of 206) during 1982-2012, with a significant (P=0.001) decrease of 22.4% observed between decade 1 (32.8%) and decade 2 (10.4%) and a further slight decrease (4.5%) between decade 2 (10.4%) and decade 3 (5.9%) (P=0.379). A third of patients had discrepancies between pre-mortem and post-mortem clinical diagnoses, with slightly over 10% of these cases revealing information that would have altered the probability of survival had it been known prior to death. More than half (59.3%) of cases had discordant cause of death as recorded in the cancer registry when compared to autopsy findings. Autopsy for children diagnosed with a PBT can provide health care professionals with important information about the accuracy of their diagnoses and evaluate the efficacy of therapy.
Department of Radiation Oncology, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, British Columbia V5Z 4E6, Canada; Pediatric Oncology Group of Ontario, 480 University Avenue, Suite 1014, Toronto, Ontario M5G 1V2, Canada. Electronic address: Haroon.Hasan@bccancer.bc.ca.
Haroon
H
Hasan
Department of Pathology and Laboratory Medicine, Division of Anatomical Pathology, British Columbia Children's Hospital, Room 2H45, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada; Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Room G227, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada.
Glenda
G
Hendson
Department of Radiation Oncology, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, British Columbia V5Z 4E6, Canada; School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada.
A Fuchsia
AF
Howard
Division of Neurology and Oncology, Department of Pediatrics, University of British Columbia Faculty of Medicine, Room 2D19, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada; Pediatric Neurology and Oncology/Hematology/BMT Programs, British Columbia Children's Hospital, Room K3-147, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada.
Juliette
J
Hukin
Department of Pathology and Laboratory Medicine, Division of Anatomical Pathology, British Columbia Children's Hospital, Room 2H45, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada; Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Room G227, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada.
Christopher
C
Dunham
School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada.
Tareq
T
Ahmed
Department of Radiation Oncology, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, British Columbia V5Z 4E6, Canada; Department of Surgery, University of British Columbia, 950 West 10th Avenue, Vancouver, British Columbia V5Z 1M9, Canada.
Andrea C
AC
Lo
Department of Radiation Oncology, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, British Columbia V5Z 4E6, Canada; Department of Surgery, University of British Columbia, 950 West 10th Avenue, Vancouver, British Columbia V5Z 1M9, Canada.
Karen
K
Goddard
D000293:Adolescent; D001344:Autopsy; D001932:Brain Neoplasms / Q000175:diagnosis*; D001955:British Columbia; D002170:Canada; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D012189:Retrospective Studies
Autopsy; Childhood cancer; Clinical discrepancies; Clinical utility; Pediatric brain tumors