Observational studyPloS one2019
Clinico-pathological discrepancies in the diagnosis of causes of death in adults in Mozambique: A retrospective observational study.
Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis 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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Cause of Death and Risk of Death for People Living With HIV Admitted to Hospital: A Systematic Review and Meta-Analysis.Journal of the International AIDS Society · 2026Pooled it
- Major discrepancy between clinical and autopsy diagnosis: a descriptive single-center analysis and its implications for the South African public health system.Frontiers in medicine · 2026Article
- Diagnostic accuracy of a simplified minimally invasive tissue sampling protocol for stillbirths in low-resource settings.BMJ global health · 2025Article
- The contribution of minimally invasive tissue sampling compared to antemortem-derived cause of death determination among inpatient child deaths: the minimally invasive tissue sampling in Malawi study.Journal of global health · 2025Article
- Strengthening identification and characterization of causes of perinatal deaths in Kaski district of Nepal (Perinatal MITS Nepal).BMC pregnancy and childbirth · 2025Article
- Comparison of Ante-Mortem Clinical Diagnosis and Final Autopsy Diagnosis: Experience from a Single Academic Centre in Pretoria, South Africa.Diseases (Basel, Switzerland) · 2024Article
- The discrepancy of antemortem clinical diagnosis and postmortem autopsy diagnosis of lung pathologies in under-five deaths and the reasons for discrepancies: a case series analysis.BMC pediatrics · 2024Article
- Burden of child mortality from malaria in high endemic areas: Results from the CHAMPS network using minimally invasive tissue sampling.The Journal of infection · 2024Article
- Verbal Autopsy to Assess Postdischarge Mortality in Children With Suspected Sepsis in Uganda.Pediatrics · 2023Article
- 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
- Causes of Death Among Infants and Children in the Child Health and Mortality Prevention Surveillance (CHAMPS) Network.JAMA network open · 2023Article
- Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years.Clinics (Sao Paulo, Brazil) · 2023Article
- Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV.PloS one · 2022Article
- Burden of Serious Bacterial Infections and Multidrug-Resistant Organisms in an Adult Population of Nepal: A Comparative Analysis of Minimally Invasive Tissue Sampling Informed Mortality Surveillance of Community and Hospital Deaths.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Observational
- 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
- Comparison of antemortem clinical diagnosis and post-mortem findings in intensive care unit patients.Virchows Archiv : an international journal of pathology · 2021Article
- Accuracy of verbal autopsy, clinical data and minimally invasive autopsy in the evaluation of malaria-specific mortality: an observational study.BMJ global health · 2021Observational
- Human toxoplasmosis in Mozambique: gaps in knowledge and research opportunities.Parasites & vectors · 2020Review
- Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out.Scientific reports · 2020Article
- Tuberculosis deaths are predictable and preventable: Comprehensive assessment and clinical care is the key.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
Corrections and comments
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Authors and funding
31 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinico-pathological discrepancies are more frequent in settings in which limited diagnostic techniques are available, but there is little information on their actual impact.
aimWe assessed the accuracy of the clinical diagnoses in a tertiary referral hospital in sub-Saharan Africa by comparison with post-mortem findings. We also identified potential risk factors for misdiagnoses.
methodsOne hundred and twelve complete autopsy procedures were performed at the Maputo Central Hospital (Mozambique), from November 2013 to March 2015. We reviewed the clinical records. Major clinico-pathological discrepancies were assessed using a modified version of the Goldman and Battle classification.
resultsMajor diagnostic discrepancies were detected in 65/112 cases (58%) and were particularly frequent in infection-related deaths (56/80 [70%] major discrepancies). The sensitivity of the clinical diagnosis for toxoplasmosis was 0% (95% CI: 0-37), 18% (95% CI: 2-52) for invasive fungal infections, 25% (95% CI: 5-57) for bacterial sepsis, 34% (95% CI: 16-57), for tuberculosis, and 46% (95% CI: 19-75) for bacterial pneumonia. Major discrepancies were more frequent in HIV-positive than in HIV-negative patients (48/73 [66%] vs. 17/39 [44%]; p = 0.0236).
conclusionsMajor clinico-pathological discrepancies are still frequent in resource constrained settings. Increasing the level of suspicion for infectious diseases and expanding the availability of diagnostic tests could significantly improve the recognition of common life-threatening infections, and thereby reduce the mortality associated with these diseases. The high frequency of clinico-pathological discrepancies questions the validity of mortality reports based on clinical data or verbal autopsy.
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