Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana

Abstract

Background

Autopsies can provide a good indication of the quality of patient care, in terms of the accuracy of clinical diagnosis and the quality of treatment given.

Designs

This was a cross-sectional study among clinicians at the Korle-Bu Teaching Hospital (KBTH) in 2012. Data were collected with a 69-item, self-administered, structured questionnaire. A total of 215 questionnaires were sent out and 119 clinicians responded. Data were collected on the benefits and utility of autopsies for medical practice, care of patients, and management of clinical wards. Survey data were analyzed by simple descriptive statistics (i.e. proportions, ratios, and percentages). Data were analyzed using SPSS version 21.

Objective

This study examined the views of clinicians regarding the utility of autopsies and their influence on clinical practice in a large teaching hospital in Ghana.

Results

Overall, clinicians in KBTH agreed that autopsy reports are useful in answering clinical questions (55/119; 46.2%), confirming or verifying clinical diagnoses (54/119; 45.4%), providing information on unsuspected diagnoses (40/119; 33.6%), and for medical education (90/119; 75.6%). Overall, 70/119 (58.8%) of clinicians agreed that autopsy findings improve completeness and reliability of death certification and provide information on clinical effectiveness of treatment and patient management. However, only 23/119 (19.3%) of sampled clinicians had personal interactions with a pathologist during autopsy processes and 93/119 (78.2%) had not attended any autopsy demonstrations in the past 6 months. Attendance of pathologists at clinicopathological meetings of clinical departments of KBTH was minimal. Unfortunately, the use of autopsy reports for auditing clinical diagnostic performance was not seen as essential.

Conclusion

Strengthening the interaction between doctors and pathologists is essential in improving the autopsy process and utilization in the hospital. KBTH should create opportunities for doctors to attend autopsy demonstrations and for pathologists to attend clinicopathological meetings in the hospital.

• autopsy
• clinical utility
• clinicians
• teaching hospital
• Ghana

Acknowledgements

We are grateful to all of the doctors in the clinical departments of the Korle-Bu Teaching Hospital who participated in the study and for the support received by staff of the Department of Community Health, University of Ghana Medical School, College of Health Sciences, Korle-Bu.

Authors' contributions

E. Tette and Y. Tettey developed the concept; A.E. Yawson and E. Tette analyzed the survey data. A.E. Yawson wrote the first draft and Y. Tettey contributed to reviewing various sections of the manuscript. All of the authors reviewed the final version of the manuscript before submission.

Conflict of interest and funding

The authors have not received any funding or benefits from industry or elsewhere to conduct this study. The views expressed in this paper are those of the authors. No official endorsement by the Korle-Bu Teaching Hospital Administration is intended or should be inferred.