# name
Performance of the minimally invasive autopsy tool for cause of
                death determination in adult deaths from the Brazilian Amazon:
                an observational study

# metadata.dc.description.abstract[].value
The uncertainty about the real burden of causes of death
                (CoD) is increasingly recognized by the international health
                community as a critical limitation for prioritizing effective
                public health measures. The minimally invasive autopsy (MIA) has
                shown to be a satisfactory substitute of the complete diagnostic
                autopsy (CDA), the gold standard for CoD determination in low-
                and middle-income countries. However, more studies are needed to
                confirm its adequate performance in settings with different
                epidemiology. In this observational study, the CoD obtained with
                the MIA were compared with the clinical diagnosis and the
                results of the CDA in 61 deaths that occurred in an infectious
                diseases referral hospital in Manaus, Brazilian Amazon.
                Concordance between the categories of diseases obtained by the
                three methods was evaluated by the Kappa statistic.
                Additionally, we evaluated discrepancies between clinical and
                complete diagnostic autopsy diagnoses. The MIA showed a
                substantial concordance with the CDA
                (Kappa\xE2\x80\x89=\xE2\x80\x890.777, 95% CI 0.608-0.946), and a
                perfect or almost perfect coincidence in specific diagnosis
                (ICD-10 code) between MIA and CDA was observed in 85% of the
                cases. In contrast, the clinical diagnosis showed a fair
                concordance with the CDA (Kappa\xE2\x80\x89=\xE2\x80\x890.311,
                95% CI 0.071-0.552). Major clinico-pathological discrepancies
                were identified in 49% of cases. In conclusion, the MIA showed a
                substantial performance for CoD identification.
                Clinico-pathological discrepancies remain high and justify the
                need for post-mortem studies, even in referral hospitals. The
                MIA is a robust substitute of the CDA for CoD surveillance and
                quality improvement of clinical practice in low- and
                middle-income settings.

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Performance of the minimally invasive autopsy tool for cause of
                death determination in adult deaths from the Brazilian Amazon:
                an observational study