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Related Experiment Videos

The reliability of autopsy diagnostics: inter-observer variation between pathologists, a preliminary report

B Veress1, V Gadaleanu, I Nennesmo

  • 1Department of Pathology, Karolinska Institute, Huddinge University Hospital, Sweden.

Quality Assurance in Health Care : the Official Journal of the International Society for Quality Assurance in Health Care
|December 1, 1993
PubMed
Summary

Pathologists showed high agreement on principal diseases during autopsy diagnostics, but moderate agreement on the immediate cause of death. Minor disease diagnosis varied more significantly among observers.

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Area of Science:

  • Forensic Pathology
  • Medical Diagnostics

Background:

  • Autopsy diagnostics are crucial for determining cause of death and disease.
  • Interobserver variation in pathological diagnoses can impact accuracy.

Purpose of the Study:

  • To analyze the agreement among pathologists in macroscopic autopsy diagnostics.
  • To assess interobserver variation in identifying principal diseases, complications, cause of death, and other diseases.

Main Methods:

  • Four pathologists reviewed 35 autopsies.
  • Diagnoses included principal disease, complications, immediate cause of death, major diseases, and minor diseases.
  • Kappa statistics were used to measure interobserver agreement.

Main Results:

  • Near-perfect agreement (kappa 0.83-0.97) was observed for the principal disease.

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  • Moderate to substantial agreement (kappa 0.43-0.75) was found for the immediate cause of death.
  • High completeness for major diseases/complications, but considerable variation in minor disease reporting.

    • Conclusions:

    • High agreement exists for principal disease identification in autopsies.
    • Discussion among pathologists is recommended for unexplained clinical findings.
    • Clinicians should determine the cause of death post-autopsy demonstration.