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Article
December 11, 1987

The Epidemiologic Necropsy-Reply

Author Affiliations

University of Kansas College of Health Sciences and Hospital Kansas City
Yale University School of Medicine Veterans Administration Medical Center New Haven, Conn
Yale University School of Medicine New Haven, Conn

University of Kansas College of Health Sciences and Hospital Kansas City
Yale University School of Medicine Veterans Administration Medical Center New Haven, Conn
Yale University School of Medicine New Haven, Conn

JAMA. 1987;258(22):3256. doi:10.1001/jama.1987.03400220053024
Abstract

In Reply.—  We thank the correspondents for their comments. We did not expect that the proposed new method would be happily accepted by epidemiologists who are content with the status quo, and we are pleased that the protests are so relatively mild. We shall respond to each letter individually.Dr Robinson fears that many of the "surprise" cases of lung cancer did not have "access to medical care in their lifetimes." Since all of these people died at a university medical center, they at least had such care during their terminal illness. As for racial composition of the necropsy population, a study at another university hospital suggests that no racial disproportion exists between deaths and selection for necropsy.1Dr Rhoads cites the old epidemiologic formula about prevalence, incidence, and duration, while ignoring the point we made in our necropsy article and elsewhere2 about the difficulty of obtaining valid

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