[Clinical diagnosis versus autopsy].

Records from 910 autopsies performed at a university hospital in Salvador, Bahia, Brazil were examined in order to assess the accuracy of clinical diagnoses of the patients' underlying causes of death. This study found inaccurate clinical diagnoses in 31% of the cases. The overall rate of diagnostic error appeared to remain fairly stable from 1970 to 1982, being highest for older patients. Thirty-six percent of the 263 cancer deaths were incorrectly diagnosed, and a number of pathologies considered relatively easy to diagnose were not always correctly identified--the underlying cause of death being incorrectly diagnosed in many of the fatalities caused by such ailments as arterial hypertension, chronic obstructive lung disease, pneumonia/bronchopneumonia, and schistosomiasis. Quite aside from their direct medical implications, diagnostic errors of the magnitude observed in this and other studies seriously jeopardize the quality of vital statistics and such statistics' usefulness for improving public health.