Discrepancies Between Clinical And Post-Mortem Diagnoses In Jamaica: An Evaluation Of Clinical Over Diagnoses

We previously documented that, at the University Hospital of the West Indies (UHWI), overdiagnoses (clinical diagnoses uncorroborated at autopsy) comprised a significant proportion of clinical discrepancies. In order to analyze these overdiagnoses and attempt to determine the diseases for which they may have been mistaken, we retrospectively extracted data from consecutive autopsies performed at the UHWI over the period January 1999 December 2000. The majority of overdiagnoses (69.8%) were made in patients hospitalized for < 2 days, and older patients (>65 years) were more likely to have a major overdiagnosis. Most overdiagnoses (77.1 %) occurred in the cardiovascular or respiratory systems and 78.3% of all overdiagnoses consisted of one of only six diseases, including those with the highest overdiagnosis rates (pneumonia, myocardial infarction and pulmonary thromboembolism). More frequent autopsy requests, particularly in older patients and/or those who die within two days of hospitalization, may assist in reducing overdiagnosis rates.