Observational studyVirchows Archiv : an international journal of pathology2019
Performance of the minimally invasive autopsy tool for cause of death determination in adult deaths from the Brazilian Amazon: an observational study.
Observational study in Virchows Archiv : an international journal of pathology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Validation of malaria-attributed deaths using verbal autopsy studies: a systematic review.Malaria journal · 2024Pooled it
- Microbiology in minimally invasive autopsy: best techniques to detect infection. ESGFOR (ESCMID study group of forensic and post-mortem microbiology) guidelines.Forensic science, medicine, and pathology · 2021Guideline
- Temporal and spatial trends in infectious disease mortality in Amazonas, Brazil, 2013-2024: implications for surveillance.Revista da Sociedade Brasileira de Medicina Tropical · 2026Article
- Accelerating Proficiency in Minimally Invasive Autopsy for Infectious Disease Diagnosis and Research: A Strategic Framework.Revista da Sociedade Brasileira de Medicina Tropical · 2026Observational
- Knowledge, acceptability, and attitudes regarding minimally invasive tissue sampling (MITS) techniques in Brazil.PLOS global public health · 2026Article
- Acceptability of minimal invasive tissue sampling (MITS) for stillbirths in Eastern Uganda.PloS one · 2025Article
- Determination of causes of adult deaths using minimally invasive tissue sampling in Gandaki province of Nepal: a multicenter hospital-based study.European journal of medical research · 2023Article
- Article
- Minimally Invasive Tissue Sampling as an Alternative to Complete Diagnostic Autopsies in the Context of Epidemic Outbreaks and Pandemics: The Example of Coronavirus Disease 2019 (COVID-19).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Minimally Invasive Tissue Sampling Findings in 12 Patients With Coronavirus Disease 2019.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Building Capacity and Infrastructure at Hospitals Implementing Minimally Invasive Tissue Sampling: Experience and Lessons Learned From Nepal, Rwanda, and Tanzania.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Minimally Invasive Tissue Sampling: A Tool to Guide Efforts to Reduce AIDS-Related Mortality in Resource-Limited Settings.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Validating a Minimally Invasive Tissue Sampling (MITS) Method in Determining Cause of Death in Stillbirths and Neonates.Children (Basel, Switzerland) · 2021Article
- Ultrasound in legal medicine-a missed opportunity or simply too late? A narrative review of ultrasonic applications in forensic contexts.International journal of legal medicine · 2021Review
- Observational
- Accuracy of verbal autopsy, clinical data and minimally invasive autopsy in the evaluation of malaria-specific mortality: an observational study.BMJ global health · 2021Observational
- Minimally Invasive Autopsy Practice in COVID-19 Cases: Biosafety and Findings.Pathogens (Basel, Switzerland) · 2021Article
- High prevalence and mortality due to Histoplasma capsulatum in the Brazilian Amazon: An autopsy study.PLoS neglected tropical diseases · 2021Article
- The evolution of minimally invasive tissue sampling in postmortem examination: a narrative review.Global health action · 2020Review
Corrections and comments
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Authors and funding
20 authors at 10 institutions in 3 countries.
Funding
Abstract
The uncertainty about the real burden of causes of death (CoD) is increasingly recognized by the international health community as a critical limitation for prioritizing effective public health measures. The minimally invasive autopsy (MIA) has shown to be a satisfactory substitute of the complete diagnostic autopsy (CDA), the gold standard for CoD determination in low- and middle-income countries. However, more studies are needed to confirm its adequate performance in settings with different epidemiology. In this observational study, the CoD obtained with the MIA were compared with the clinical diagnosis and the results of the CDA in 61 deaths that occurred in an infectious diseases referral hospital in Manaus, Brazilian Amazon. Concordance between the categories of diseases obtained by the three methods was evaluated by the Kappa statistic. Additionally, we evaluated discrepancies between clinical and complete diagnostic autopsy diagnoses. The MIA showed a substantial concordance with the CDA (Kappa = 0.777, 95% CI 0.608-0.946), and a perfect or almost perfect coincidence in specific diagnosis (ICD-10 code) between MIA and CDA was observed in 85% of the cases. In contrast, the clinical diagnosis showed a fair concordance with the CDA (Kappa = 0.311, 95% CI 0.071-0.552). Major clinico-pathological discrepancies were identified in 49% of cases. In conclusion, the MIA showed a substantial performance for CoD identification. Clinico-pathological discrepancies remain high and justify the need for post-mortem studies, even in referral hospitals. The MIA is a robust substitute of the CDA for CoD surveillance and quality improvement of clinical practice in low- and middle-income settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.