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- W2188793734 abstract "Background: Despite technological advances, the comparative study between clinical diagnoses performed and those collected at cadaver examination may reveal discrepancies. Objectives: (a) determine levels of agreement between clinical and autopsy diagnoses based on the results of necropsies performed at the Servico de Verificacao de Obitos (SVO); (b) identify the percentage of correct diagnoses, the main causes of death and their distribution by age and sex. Material/Methods: In the years 2003/2004, of the 1,637 necropsies performed at SVO/RN, 733 examinations (44.74%) originated in public hospitals and were accompanied by their respective clinical diagnoses. The causes of death, determined by autopsy, were grouped according to organic systems, and after calculating the Positive Predictive Value (PPV) and diagnostic Sensitivity (S) of the individual causes of death, compared to clinical diagnoses. The percentage of correct diagnoses and cause of death frequency were also identified, as well as their distribution by age and sex. Results: Of the 733 necropsies performed, 421 showed concordant clinical and necropsy diagnoses (57.43%, S = 0.70). False-negative (FN) and false-positive (FP) were detected in 23.70% and 18.70% of the cases, respectively. The highest percentage and diagnostic sensitivity values (S) were identified in central nervous system (CNS) infirmities (73.68%, S = 0.84) and the greatest error indices were detected in cases related to the cardiovascular system (45.78%, S = 0.61). No correct diagnoses were made in the cases of aortic dissection, registering the lowest S and PPV values. The main cause of death was bacterial pneumonia (16.37%), properly diagnosed in 52.50% of the cases, followed by systemic arterial hypertension (SAH) (16.10%). Death occurred predominantly in the eighth decade (19.92%), in both sexes (p=0.10). An important percentage of the deaths were verified in the first decade (10.37%). Conclusions: Despite advances in disease diagnosis, the autopsy remains vital for ensuring quality in medical care, serving to correct future diagnostic errors. The present results indicate percentages and indices of diagnostic accuracy above those cited in the literature, not signifying, necessarily, excellence in medical care." @default.
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- W2188793734 date "2006-01-01" @default.
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- W2188793734 title "Analysis of the sensitivity and positive predictive value of clinical diagnoses in 733 hospital deaths: Comparison with necropsy findings" @default.
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