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Difference between revisions of "Autopsy"
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'''Autopsy''' was a mainstay of pathology.. | '''Autopsy''' was once a mainstay of pathology. It is now in decline and uncommonly done. Fetal autopsy is dealt with in a separate article called ''[[fetal autopsy]]''. | ||
==Value of autopsy== | |||
A significant number of major findings cannot be diagnosed without histology;<ref name=pmid16324191>{{Cite journal | last1 = Roulson | first1 = J. | last2 = Benbow | first2 = EW. | last3 = Hasleton | first3 = PS. | title = Discrepancies between clinical and autopsy diagnosis and the value of post mortem histology; a meta-analysis and review. | journal = Histopathology | volume = 47 | issue = 6 | pages = 551-9 | month = Dec | year = 2005 | doi = 10.1111/j.1365-2559.2005.02243.x | PMID = 16324191 }}</ref> thus, without an autopsy they cannot be diagnosed. Autopsies can be regarded as a form of [[quality control]]. | |||
One large review in ''JAMA'' suggests that approximately:<ref name=pmid12783916>{{cite journal |author=Brian Gallagher, Burton EC, McDonald KM, Goldman L |title=Changes in rates of autopsy-detected diagnostic errors over time: a systematic review |journal=JAMA |volume=289 |issue=21 |pages=2849–56 |year=2003 |pmid=12783916 |doi=10.1001/jama.289.21.2849}}</ref> | |||
* 25% of autopsies reveal a finding that would have changed clinical management. | |||
* 5% of autopsies reveal a missed [[diagnosis]] that probably affected the outcome. | |||
==Consent== | ==Consent== | ||
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*There are religious objections to autopsy among Jews and Muslims.<ref name=Ref_HospAuto43>{{Ref HospAuto|43}}</ref><ref name=Ref_HospAuto47>{{Ref HospAuto|47}}</ref> | *There are religious objections to autopsy among Jews and Muslims.<ref name=Ref_HospAuto43>{{Ref HospAuto|43}}</ref><ref name=Ref_HospAuto47>{{Ref HospAuto|47}}</ref> | ||
*It is ''not'' considered good practise to agree to restrictions that will impair a complete assessment, e.g. "stop as soon as one has the cause of death", especially in the medicolegal context (when the extent of the autopsy is at the pathologist's discretion). It is often said that... ''incomplete autopsies give incomplete answers''. | *It is ''not'' considered good practise to agree to restrictions that will impair a complete assessment, e.g. "stop as soon as one has the cause of death", especially in the medicolegal context (when the extent of the autopsy is at the pathologist's discretion). It is often said that... ''incomplete autopsies give incomplete answers''. | ||
==External exam== | ==External exam== | ||