Quality Assessment and Management: An Overview of Concordance and Discordance Rates Between Clinical and Autopsy Diagnoses

Autopsy diagnoses have traditionally been used as the “Gold Standard” for determining the cause of death. The purpose of this study was to use autopsy to determine the rate of concordance and discordance between clinical diagnoses and post-mortem findings in patients admitted to the hospitals of the Saskatoon Health Region. A retrospective record review of the medical and autopsy charts was carried out by three independent observers for all the deceased adult in-patients admitted during 2006 to 2008. In accordance with selection criteria, 102 (59 males; 43 females) cases were assessed. The concordance rate between clinical and autopsy diagnosis was found to be 86.3%. The discordance rate was 12.7% and in 1.0% was inconclusive. We encourage residents and physicians to continue using autopsy as an important tool to extend our understanding of disease processes.