1. [Analysis of the quality of clinical diagnosis based on autopsy data].
- Author
-
Kalinichev GA, Volodin IuP, and Dobin VL
- Subjects
- Adolescent, Adult, Aged, Autopsy, Cardiovascular Diseases mortality, Cardiovascular Diseases pathology, Clinical Laboratory Techniques statistics & numerical data, Diagnostic Errors, Female, Humans, Male, Middle Aged, Neoplasms mortality, Neoplasms pathology, Russia, Tuberculosis mortality, Tuberculosis pathology, Cardiovascular Diseases diagnosis, Clinical Laboratory Techniques standards, Neoplasms diagnosis, Quality of Health Care, Tuberculosis diagnosis
- Abstract
The material is based on the autopsy findings collected over 15 years (1975-1989). Findings related to 748 fatal outcomes were subjected to analysis in which 90 (12%) cases were misdiagnosed regarding the principal disease. A percentage of diagnostic errors with respect to tuberculosis was 1.8 on the whole and in the diagnosis of clinical forms and phases it was considerably higher-15.9 and 19.4, respectively. Hyperdiagnosis was typical of disseminated tuberculosis and caseous pneumonia, while hypodiagnosis--of primary, fibrocavernous tuberculosis and post-tuberculous changes. A percentage of hypodiagnosis in nontuberculous pathology varied from 12.5 to 50. Dynamic observation by the five-year plans demonstrated an increase in the percentage of misdiagnosis of the concurrent pathology and its decrease when the phase of a specific process was established. Purely medical errors accounted for 75% of misdiagnosis.
- Published
- 1992