# name
Contribution of the clinical information to the accuracy of the minimally invasive and the complete diagnostic autopsy

# metadata.dc.description.abstract[].value
Although autopsy diagnosis includes routinely, a thorough
                evaluation of all available pathological results and also of any
                available clinical data, the contribution of this clinical
                information to the diagnostic yield of the autopsy has not been
                analyzed. We aimed to determine to which degree the use of
                clinical data improves the diagnostic accuracy of the complete
                diagnostic autopsy (CDA) and the minimally invasive autopsy
                (MIA), a simplified pathological postmortem procedure designed
                for low-income sites. 264 coupled MIA and CDA procedures (112
                adults, 57 maternal deaths, 54 children and 41 neonates) were
                performed at the Maputo hospital, Mozambique. We compared the
                diagnoses obtained by the MIA blind to clinical data (MIAb), the
                MIA adding the clinical information (MIAc), and the CDA blind to
                clinical information (CDAb), with the results of the gold
                standard, the CDA with clinical data, by comparing the ICD-10
                codes and the main diagnostic classes obtained with each
                evaluation strategy (MIAb, MIAc, CDAb, CDAc). The clinical data
                increased diagnostic coincidence to the MIAb with the gold
                standard in 30/264 (11%) cases and modified the CDAb diagnosis
                in 20/264 (8%) cases. The increase in concordance between MIAb
                and MIAc with the gold standard was significant in neonatal
                deaths (kappa increasing from 0.404 to 0.618, P=.0271), adult
                deaths (kappa increasing from 0.732 to 0.813, P=.0221) and
                maternal deaths (kappa increasing from 0.485 to 0.836,
                P<.0001). In conclusion, the use of clinical information
                increases the precision of MIA and CDA and may strengthen the
                performance of the MIA in resource-limited settings.

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

# metadata.dc.title[].value
Contribution of the clinical information to the accuracy of the minimally invasive and the complete diagnostic autopsy