[Comparative study of preliminary and definitive anatomo-pathological diagnoses in 375 autopsies in adults]

For the past 5 years the institute of pathology of the University of Lausanne has been delivering both provisional and final autopsy reports. The provisional reports are based mainly upon macroscopic findings, whereas the final reports include the information provided by supplementary investigations such as microscopy, histochemistry, more rarely electron microscopy, immunohistochemistry and/or microbiology. The reliability and usefulness of the provisional reports were analyzed by systematic comparison between the provisional and final reports of 375 adult post-mortems as well as through an inquiry among requesting physicians. No significant difference was found between the two reports in 77.1% of the cases. In 22.1% the supplementary investigations provided information which had a bearing on the final diagnosis and made it possible to complete or correct the macroscopic diagnosis. In 0.8% the significant difference was due to the omission, in the provisional report, of an obvious macroscopic diagnosis. Finally, 95% of the consulted physicians found the provisional reports useful because of the precise written and particularly rapid information they provided. These results not only demonstrated that the establishment of such provisional reports is fully justified, but further emphasize the fundamental and complementary role played by the final autopsy reports.