Validity of Diagnostic Evidence for Deceased Cases in Hospitals

Key words: 
• Validity /
• Diagnosis criteria /
• Diagnostic evidence /
• Laboratory examination

Abstract: Objective To determine the validity of the diagnostic evidence for deceased cases in hospitals. Methods All information collected from medical records of the deceased cases in tertiary care health facilities was input into our database. Four diagnosis levels were determined based on level of diagnostic evidence: level I was based on autopsy, pathology or operative exploration, level Ⅱ on physical and laboratory tests plus expert clinical judgment, level Ⅲ on expert clinical judgment, level Ⅳ on postmortem assumptions. After the diagnostic evidence of each deceased case was reviewed by a panel of three experts, the diagnostic level of each diagnosis was determined. Results Among the 2102 medical cases for verbal autopsy study, only 26 (1.24%) afforded diagnostic evidence for level Ⅲ. Among the level Ⅲ evidence-based cases of death, the major causes of death were cardiovascular diseases, respiratory diseases, and gastroenterological diseases. According to some special symptoms and medical histories, these cases could be diagnosed by comprehensive clinical judgment. Only one case met the criteria for level Ⅳ. Conclusion Level Ⅰ diagnostic evidence is hard to attain in China because of the traditional concept and economic restriction. The causes for 2101 deaths can be validated by level Ⅱ or Ⅲ diagnostic evidence.