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Related Experiment Video

Updated: Jul 15, 2025

Symmetric Bihemispheric Postmortem Brain Cutting to Study Healthy and Pathological Brain Conditions in Humans
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Error codes at autopsy to study potential biases in diagnostic error.

Bruce I Goldman1, Rajnish Bharadwaj1, Michelle Fuller1

  • 1Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.

Diagnosis (Berlin, Germany)
|October 4, 2023
PubMed
Summary
This summary is machine-generated.

Autopsy diagnostic error (DE) rates increased over time. Female cases showed more DEs initially, while later periods revealed undocumented malignancy in males and higher error rates in nonwhite individuals, suggesting potential biases.

Keywords:
International Classification of Diseasesautopsydiagnostic errorregistries

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Area of Science:

  • Forensic Pathology
  • Medical Diagnostics
  • Health Disparities

Background:

  • Current autopsy guidelines lack methods to identify diagnostic error (DE) causes.
  • Autopsy data registries can be leveraged to investigate factors influencing DE.

Purpose of the Study:

  • To determine if gender and race are associated with the frequency of diagnostic error identified during autopsies.
  • To analyze trends in diagnostic error coding and identify potential biases.

Main Methods:

  • Utilized autopsy reports from 2012-2019, coded using ICD-9/ICD-10 for diagnoses and specific error types (UNDOC, UNCON).
  • Assessed adult autopsy cases for DE related to sex and race, comparing data from 2012-2015 and 2015-2019 periods.
  • Analyzed statistical significance of observed differences in DE frequencies.

Main Results:

  • Overall DE frequency increased from 65.9% (2012-2015) to 72.1% (2015-2019).
  • Female cases showed higher DE frequency (total errors, UNDOC, UNCON) from 2012-2015 (p<0.0001).
  • From 2015-2019, undocumented malignancy was higher in males (p=0.0065), and nonwhite subjects had higher rates of unconfirmed cause of death and overall error proportions (p<0.0003).

Conclusions:

  • Autopsy diagnostic error coding can reveal potential biases related to sex and race.
  • Systematic coding of DE provides valuable insights into diagnostic accuracy and potential disparities.