The Reliability of Autopsy Diagnostics: Inter-observer Variation between Pathologists, a Preliminary Report
- 1 December 1993
- journal article
- research article
- Published by Oxford University Press (OUP) in International Journal for Quality in Health Care
- Vol. 5 (4) , 333-337
- https://doi.org/10.1093/intqhc/5.4.333
Abstract
The aim of the study was to analyse the agreement between pathologists regarding macroscopic autopsy diagnostics. Four pathologists examined 35 autopsies and determined the principal disease and its complications, the immediate cause of death, other major diseases and their complications, and minor diseases. The participants were paired and their diagnoses were analysed by using kappa statistics for inter-observer variation. The agreement on the principal disease was almost perfect between the participants (k values between 0.83 and 0.97), whereas that on the immediate cause of death was moderate/substantial (k values between 0.43–0.75). The list of all other major diseases and their complications was almost complete for each observer, but that of the minor diseases showed a more considerable variation. In spite of the high level of agreement it is recommended that the autopsy findings be discussed among pathologists if the clininal picture cannot be explained satisfactorily, and that the cause of death be determined by the clinicians after the demonstration of the autopsy.Keywords
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