With the advent of modern diagnostic technology, use of the autopsy as a means of assessing diagnostic accuracy has declined precipitously. However, the rate of misdiagnosis found at autopsy has not changed. The purpose of the present study was to analyze the discrepancies obtained from the comparison between clinical and autopsy diagnosis in a tertiary care hospital. Medical records, autopsy reports and death certificates were analyzed for 59 consecutive autopsies performed over a 2 yrs period from Jan 2009 to Dec 2010, who died in a tertiary care hospital in Delhi. Errors in clinical diagnosis were assigned to one of four classes as suggested by Goldman. Total Deaths were 1055 and total 59 (5.6%) autopsies were performed. The mean age of patients excluding neonates was 36.2 years (range 1 day -59 days) and average length of stay was 6.2 days (range few hours to 42 days). Major discrepancies involving cause of death was 17 (28.8%). Additional findings not detected antemortem were 42 (71.1%). The class I error were 10 (23.7%) of Class II error, 13 (22.1%) of class II errors, class III 20 (32.3%) and class IV were 7 (11.9%). In 9 cases not enough information was found in the medical records to carry out a diagnostic correlation analysis. Discrepancies between Clinical and Autopsy Diagnosis continues to be high. Unexpected findings are identified relatively more frequently at autopsy, when the autopsy is proceed by a short hospital stay.The autopsy remains a vital tool for determining diagnostic accuracy, despite modern modalities of clinical investigation and diagnosis.

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Khethmal P

Senior Demonstrator, Dept of Pathology, Government Medical College (RJMES), Pali, Rajasthan, India