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January 5, 1976

Postmortem Examination

Author Affiliations

Mount Sinai Hospital Hartford, Conn

JAMA. 1976;235(1):21. doi:10.1001/jama.1976.03260270011003

To the Editor.—  Burrows pointed out that autopsies are expensive and that they consume a considerable amount of the pathologist's time. I agree with these premises but I disagree with his suggestion that the solution is the selection of "clinically puzzling" cases for study, while excluding from study at autopsy cases that are "routine."Britton,1,2 a Swedish pathologist, in a study of 383 autopsy cases among 400 consecutive deaths (an autopsy rate of 93%), in contrast to Dr Burrows' lone effort, worked with a panel of clinicians. Clinical diagnoses were classified by the clinicians as "fairly certain" or "probable." The "fairly certain" category is comparable to what others refer to as "routine" cases. The total error rate was 25% in the "fairly certain" category, and 45% in the "probable" category. Britton quite rightly points out that "Obviously, such cases cannot be excluded from autopsy on the grounds that errors