TY - THES ID - 136978695 TI - Diagnostic errors in medicine revealed due to post mortem investigation: a systematic review of the literature in the last 5 years. AU - Van Dyck, Stien AU - Van de Voorde, Wim AU - KU Leuven. Faculteit Geneeskunde. Opleiding Master in de geneeskunde (Leuven) PY - 2019 PB - Leuven KU Leuven. Faculteit Geneeskunde DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:136978695 AB - Context: Discrepancies still exist between clinical diagnoses and autopsy-diagnoses. Autopsy is a useful tool to assess diagnostic discrepancies. Objective: To assess discrepancies between clinical diagnoses and post mortem diagnoses in literature published in the last five years, not focussed on a specific hospital department. Study selection: We searched Cochrane, Embase and Pubmed for observational studies reporting diagnostic errors confirmed by autopsy, published from the first of January 2013 to the end of June 2018. For the classification of the diagnostic errors, studies must use the Goldman criteria for classification. Data extraction: We abstracted following data: number of deaths, number of autopsies used in the studies, autopsy rate, number of diagnostic errors and underlying diagnoses. Descriptive statistics were calculated. Results: The prevalence of Class I diagnostic errors ranged from 1,4% to 49,6% with a weighted mean of 11,9%. The prevalence of Class II errors ranged from 2,1% to 22,2% (weighted mean 9,43%), the prevalence of Class III errors ranged from 3,6% to 44,93% (weighted mean 14,88%), the prevalence of Class IV errors ranged from 2,4% to 36,71% (weighted mean 34,07%) and the prevalence of complete concordance between antemortem diagnosis and post mortem diagnosis ranged from 17,7% to 79% with a weighted mean of 49,46%. Conclusion: This systematic review proved that in 11,59% of the autopsies, there is a difference between clinical diagnoses and post mortem diagnoses that could be lethal (Class I diagnostic error). In 9,43% of the autopsies, a Class II diagnostic error was discovered. This review demonstrates that post mortem examination is important in detecting diagnoses that would otherwise be missed. ER -