Carvalho F M, Palomo V, Widmer M R, Cruz M, Cruz C
Universidade Federal da Bahia, Departamento de Medicina Preventiva, Salvador, Bahia, Brasil.
Bol Oficina Sanit Panam. 1991 Mar;110(3):213-8.
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.
为评估患者潜在死因临床诊断的准确性，对巴西巴伊亚州萨尔瓦多市一家大学医院进行的910例尸检记录进行了检查。该研究发现31%的病例临床诊断不准确。从1970年到1982年，诊断错误的总体发生率似乎保持相当稳定，老年患者的发生率最高。263例癌症死亡病例中有36%被错误诊断，一些被认为相对容易诊断的病理情况也并非总能被正确识别——在许多由动脉高血压、慢性阻塞性肺病、肺炎/支气管肺炎和血吸虫病等疾病导致的死亡病例中，潜在死因被错误诊断。除了其直接的医学影响外，本研究及其他研究中观察到的如此严重程度的诊断错误严重危及生命统计数据的质量及其对改善公共卫生的效用。
