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Are autopsies obsolete

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TLDR
Old-fashioned low-technology autopsies can uncover many important diagnoses missed by modern high-technology medicine, according to this and similar studies suggest.
Abstract
To determine the current frequency of discovering important diagnoses at autopsy, the diagnoses made in all complete or "no head" autopsies during 1994 at a major tertiary care transplantation referral center were retrospectively compared with the diagnoses made antemortem. Of 176 autopsies, 79 (44.9%) revealed 1 or more undiagnosed causes of death. Of the 123 undiagnosed causes of death, 13 were sole immediate causes of death, 72 were one of multiple immediate causes, 22 were intervening causes, and 16 were underlying causes. The causes of death were as follows: infections, 34; infarctions, 11; malignant neoplasms, 8; pulmonary emboli, 7; gastrointestinal ulcers, 7; hemorrhages, 6; thromboses, 3; amyloidosis, 1; genetic hemochromatosis, 1; and cardiac tamponade, 1. Of 35 autopsies of transplant recipients, 16 (46%) disclosed undiagnosed causes of death, compared with 63 (44.7%) of 141 autopsies of patients who had not received transplants. Approximately two thirds of the undiagnosed causes of death were judged to be treatable conditions. This and similar studies suggest that old-fashioned low-technology autopsies can uncover many important diagnoses missed by modern high-technology medicine.

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Changes in Rates of Autopsy-Detected Diagnostic Errors Over Time

TL;DR: Shojania et al. as discussed by the authors presented the results of a study at the University of California, San Francisco (UCSF) and Stanford University (Stanford, Calif).
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Changes in rates of autopsy-detected diagnostic errors over time: a systematic review.

TL;DR: The possibility that a given autopsy will reveal important unsuspected diagnoses has decreased over time, but remains sufficiently high that encouraging ongoing use of the autopsy appears warranted.
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Minimally Invasive Autopsy: An Alternative to Conventional Autopsy?

TL;DR: MIA is a feasible procedure with high diagnostic performance for detection of common causes of death such as pneumonia and sepsis; MIA failed to demonstrate cardiac diseases, such as acute myocardial infarction and endocarditis, as underlying cause of death.
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Death certification errors at an academic institution.

TL;DR: The rate of major (grade IV) death certification errors at this academic setting is high and is consistent with major error rates reported by other academic institutions.
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Low-Tech Autopsies in the Era of High-Tech Medicine: Continued Value for Quality Assurance and Patient Safety

George D. Lundberg
- 14 Oct 1998 - 
TL;DR: This data indicates that early intervention in low-birth-weight premature infants through age 5 from the Infant Health and Development Program enhances the outcomes of low birth weight, premature infants: a multisite, randomized trial.
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