An analysis of 60 years of autopsy data from Zhejiang university in Hangzhou, China.

CONTEXT: The autopsy rate gradually decreased during 1950-1999, and increased during the most recent decade (2000-2009). The diagnostic inaccuracy rate was continuously high during the 60 years. OBJECTIVE: To investigate disagreement between the pathological and clinical diagnosis during 60 years (1950-2009). DATA SOURCES: A 60-year retrospective study was carried out on the 4140 autopsy cases performed in Zhejiang University School of Medicine. RESULTS: The highest number of cases was 1037 during 1960-1969, while the lowest was 102 during 1990-1999. During the 1999-2009 period, 978 cases were completed, which ranked second within the 60 years. The total clinical misdiagnosis rate was 46.38%, while the highest was 73.82% in 2000-2009. During the 60 years, the diseases associated with highest diagnostic inaccuracy rates were circulatory diseases (76.97%), cancer (60.99%), and brain diseases (54.48%). The invasive fungal infection rate was 1.84% of the 4140 cases, and the diagnostic inaccuracy rate for this condition reached as high as 86.10%. In the autopsied disease spectrum over the 60 years, the most common diseases were respiratory (1349, 32.58%), circulatory (495, 11.96%), and brain diseases (424, 10.24%). CONCLUSION: Although the number of autopsies decreased from 1950 to 1999, it increased from 2000 to 2009, while the discordance rate between clinical and autopsy diagnosis remained high throughout

List of the distribution of all 182 cases of cancer as well as examples of misdiagnosis and undiagnosed diseases.

<p>List of the distribution of all 182 cases of cancer as well as examples of misdiagnosis and undiagnosed diseases.</p

Major diagnostic error rates in the different identical centers in China.

<p>Major diagnostic error rates in the different identical centers in China.</p

List of all 76 invasive fungal infection cases during the 60 years autopsy cases.

<p>List of all 76 invasive fungal infection cases during the 60 years autopsy cases.</p

Comparison of the autopsy-determined pathological diagnosis and the clinical diagnosis.

<p>Comparison of the autopsy-determined pathological diagnosis and the clinical diagnosis.</p

The ages and genders categorization of 4140 autopsied individuals in the different times.

<p>The ages and genders categorization of 4140 autopsied individuals in the different times.</p

A total of 4140 autopsy cases were conducted between 1950 and 2009.

<p>Of these, 2785 were male and 1355 female. The largest number of cases occurred between 1960 and 1969. The fewest were recorded between 1990 and 1999(Figure 1A). The Adult and the infant groups are the major part in all cases (Figure 1B).</p

Within the 60 years, based on the disease distribution, respiratory diseases ranked the highest, followed by circulatory diseases and brain diseases (Figure 2A).

<p>In terms of the diagnostic error rate, the 2000–9 group was the highest. Second was the 1970–9 group, and third was the 1990–9 group (Figure 2B). In terms of the diseases, the most misdiagnosed were in the circulatory system. Ranking second among the categories with misdiagnoses was tumor, followed in descending order by parasitic diseases, and diseases of the genitourinary system, alimentary tract, and respiratory tract (Figure 2C).</p