Decline in autopsy rate leads to underdiagnosis of fungal disease?

Surgeon at Wythenshawe Hospital, Manchester, UKAutopsy rates in many European, Asian and American countries have declined steadily - down to 3% in Germany by 1999 compared with 10% as recently as 1980. Overall rates are much higher in the United States but there has still been a major decline from 67% to 26% between 1989 and 2003.

Reasons for this decline are given as a dislike amongst the public for them to be carried out, the introduction of requirement for consent by next of kin and the cost of performing an autopsy.

Statistics show that 20-30% of patients who die in hospital have lesions or infections that are only detected via autopsy - many of which are fungal infections. The rates of fungal infection causing death are therefore underestimated in the collection of national statistics unless autopsies are performed.

National health provision, medical education and training in many countries is driven in part by 'cause of death' statistics, so under-representation of fungal infections in these figures leads to inadequacies in many areas, not least that of ensuring a clinician has accurate statistics on which to base clinical judgement.

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