Changes in rates of autopsy-detected diagnostic errors over time: a systematic review.
Shojania KG, Burton EC, McDonald KM, Goldman L. JAMA. 2003;289:2849-2856.
A systematic review of the literature from 1966 to 2002 was performed to determine the rate at which autopsies detect important, clinically missed diagnoses and the extent to which this rate has changed over time. Fifty-three autopsy series were studied that reported diagnoses involving a primary cause of death (major errors) and those likely to have affected patient outcome (class I errors). The median major error rate was 23.5% (4.1% to 49.8%), and the median class I error rate was 9.0%. Over time, there were relative decreases in major errors and class I errors of 19.4% and 33.4% per decade, respectively. Despite these decreases, the authors estimate that for modern U.S. institutions, there is likely a major error rate from 8.4% to 24.4% and a class I error rate from 4.1% to 6.7%.
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Shojania KG. AHRQ WebM&M [serial online]. March 2004.
Overestimation of clinical diagnostic performance caused by low necropsy rates.
Shojania KG, Burton EC, McDonald KM, Goldman L. Qual Saf Health Care. 2005;14:408-413.
The impact of declining clinical autopsy: need for revised healthcare policy.
Xiao J, Krueger GR, Buja LM, Covinsky M. Am J Med Sci. 2009;337:41-46.
Checklists to reduce diagnostic errors.
Ely JW, Graber ML, Croskerry P. Acad Med. 2011;86:307-313.
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