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加强死后诊断:法医病理学领域十余年的ISO 17020认可及指南实施情况

Enhancing postmortem diagnostics: over a decade of ISO 17020 accreditation and guidelines implementation in forensic pathology.

作者信息

Van Den Bogaert Wouter, Wuestenbergs Joke, Bekaert Bram, Dequeker Elisabeth, Van de Voorde Wim

机构信息

Forensic Biomedical Sciences, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.

Department of Forensic Medicine, University Hospitals Leuven, Herestraat 49, Leuven, B-3000, Belgium.

出版信息

Forensic Sci Med Pathol. 2025 Jun;21(2):682-689. doi: 10.1007/s12024-024-00918-0. Epub 2024 Nov 28.

Abstract

Forensic autopsies remain indispensable for accurately determining the cause and manner of death. However, pathologists face significant challenges inherent to the complex process of postmortem diagnostics (PMD), including the potential for diagnostic errors. The implementation of quality assurance (QA) mechanisms is crucial for minimizing these errors. Nonetheless, the lack of QA programs, specifically tailored for forensic pathology, continues to pose a significant obstacle. This article explores the enhancement of PMD after the adoption of ISO 17020 accreditation at a Belgian forensic institute in 2010. Drawing on over a decade of experience, it details on the development and implementation of label-specific standard operating procedures (SOPs) designed to address the various types of deaths in forensic practice. Additionally, it underscores the necessity of adapting international directives from leading organizations into effective local protocols, aiming to standardize practices and improve efficacy. Through a comparative review of existing international guidelines, this study provides forensic pathologists and institutions worldwide with practical strategies for qualitative standardization and improving their PMD.

摘要

法医尸检对于准确确定死亡原因和方式仍然不可或缺。然而,病理学家在死后诊断(PMD)这一复杂过程中面临着诸多固有挑战,包括诊断错误的可能性。实施质量保证(QA)机制对于将这些错误降至最低至关重要。尽管如此,缺乏专门为法医病理学量身定制的QA计划仍然是一个重大障碍。本文探讨了比利时一家法医机构在2010年采用ISO 17020认可后PMD的改进情况。凭借十多年的经验,详细介绍了旨在应对法医实践中各类死亡情况的特定标签标准操作程序(SOP)的制定和实施。此外,强调了将领先组织的国际指令转化为有效的地方协议的必要性,旨在规范实践并提高效率。通过对现有国际指南的比较审查,本研究为全球法医病理学家和机构提供了定性标准化和改进其PMD的实用策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80ed/12325508/d0eaa98ad9ad/12024_2024_918_Fig1_HTML.jpg

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