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Factors which influence necropsy requests: a psychological approach
R D Start1, M J Hector-Taylor, D W Cotton
1Department of Pathology, Sheffield University Medical School.
Journal of Clinical Pathology
|March 1, 1992
Summary
Clinicians are more likely to request a necropsy for younger patients with low diagnostic confidence and favorable family attitudes. A clinician's interest in necropsies significantly impacts their decision to request one.
Area of Science:
- Medical research
- Pathology
- Clinical decision-making
Background:
- Necropsy (autopsy) rates have been declining, impacting medical education and research.
- Understanding factors influencing necropsy requests is crucial for improving diagnostic accuracy and medical knowledge.
Purpose of the Study:
- To identify key factors influencing clinicians' decisions to request a necropsy.
- To analyze the impact of patient demographics, diagnostic certainty, family consent, and practice conditions on necropsy requests.
Main Methods:
- Factorial design incorporating patient age, diagnostic confidence, and relatives' attitudes in medical and surgical questionnaires.
- Repeated measures factorial analysis of variance to assess factor interactions.
- Examination of the influence of clinician's pre-existing interest in necropsies.
Main Results:
- Younger patients, lower diagnostic confidence, and favorable relative attitudes increased necropsy request likelihood.
- Practice conditions did not significantly influence requests; no overall difference between medical and surgical groups.
- Surgeons requested more necropsies when surgical intervention was absent; clinician interest consistently correlated with higher request rates.
Conclusions:
- Questionnaires effectively measured factors influencing necropsy requests.
- Strategies to increase necropsy rates should emphasize enhancing clinicians' perception of the modern necropsy's value.