Reviving the Autopsy as a Diagnostic Error–Reduction Tool

Abstract

Errors are estimated to occur in 10% to 15% of all diagnoses and can lead to significant harm and costs. An autopsy can reveal clinically significant diagnoses missed before death. Multiple studies have reported poor concordance between clinical and autopsy diagnoses; thus, autopsy remains a powerful tool for the study of diagnostic errors. Although there are benefits to autopsy in the era of advanced diagnostic technology, many barriers exist. In this article, we discuss the role of autopsy in reducing diagnostic errors and make several recommendations of how to invigorate efforts to support autopsy as a potential diagnostic error–reduction tool. A resurgence of autopsy as a learning tool will require not only focus on the actions of requesting physicians or pathologists, but also a systems-based approach, including nonphysician personnel, health information technology, reimbursement initiatives, and incentives to promote the use of autopsy. * ADASP : Association of Directors of Anatomic and Surgical Pathology; ACGME : Accreditation Council for Graduate Medical Education; ABMS : American Board of Medical Specialties; EHRs : electronic health records