BACKGROUND: Between 1972 and 1984 the diagnostic arsenal has much changed due to wide application of endoscopy, sonography and computed tomography. PATIENTS AND METHOD: Using the data from patients undergoing autopsy in the years 1972, 1977, 1981, and 1984, it was assessed how many of the diagnostic techniques had been used and to what extent the premortal diagnosis of abnormalities found at autopsy improved during this period. RESULT: While the number of autopsies declined from 113 in 1977 to 66 in 1984, the number of diagnostic techniques used increased continuously (94, 107, 118, and 140, amounting to 0.83, 1.34, 1.76 and 2.12 per patient). The premortal detection of abdominal abnormalities increased globally from 16.8 to 32.5%. This increase was largely due to better diagnosis of liver and gallbladder abnormalities which were in most cases of little relevance. CONCLUSION: Thus, the massive increase of the application of technical diagnostic tools leads only to a limited premortal diagnostic gain while costs are significant.
BACKGROUND: Between 1972 and 1984 the diagnostic arsenal has much changed due to wide application of endoscopy, sonography and computed tomography. PATIENTS AND METHOD: Using the data from patients undergoing autopsy in the years 1972, 1977, 1981, and 1984, it was assessed how many of the diagnostic techniques had been used and to what extent the premortal diagnosis of abnormalities found at autopsy improved during this period. RESULT: While the number of autopsies declined from 113 in 1977 to 66 in 1984, the number of diagnostic techniques used increased continuously (94, 107, 118, and 140, amounting to 0.83, 1.34, 1.76 and 2.12 per patient). The premortal detection of abdominal abnormalities increased globally from 16.8 to 32.5%. This increase was largely due to better diagnosis of liver and gallbladder abnormalities which were in most cases of little relevance. CONCLUSION: Thus, the massive increase of the application of technical diagnostic tools leads only to a limited premortal diagnostic gain while costs are significant.