5 Clin Pathol 1997;50:548-552 Papers A survey of general practitioners' views on autopsy reports Samantha Karunaratne, Emyr W Benbow Abstract Aims-To study the views of general practi- tioners on the quality and utility of autopsy reports, and on autopsies in general. Methods-For a period of six months, a questionnaire was enclosed with each autopsy report sent to a general practitioner from the mortuary at Man- chester Royal Infirmary. Results-Most (93.3%) general practition- ers found the autopsy report useful, and many (66.7%) thought the bereaved rela- tives would do so too. However, only a minority (25.2%) would discuss the report with the relatives. A considerable proportion (20.0%) found the cause of death surprising, and a significant number (10.4%) felt the report would modify their future clinical practice. There was approval of autopsies in gen- eral, with most (88.6%) agreeing that autopsies reveal lesions not detected in life, and many (74.4%) indicating that loss of the autopsy would impair severely the monitoring of clinical standards. Conclusions-General practitioners ap- preciate autopsy reports, which may have a significant impact on clinical practice. Autopsy reports provide both case audit and information for relatives. (C Clin Pathol 1997;50:548-552) Keywords: autopsy; family practice; grief; medical audit Department of Pathological Sciences, Stopford Building, University of Manchester, Oxford Road, Manchester M13 9PT, UK Correspondence to: Dr Benbow. Accepted for publication 8 April 1997 Autopsy rates have been declining gradually over several decades in many parts of the world' with few exceptions,6`8 despite the pro- cedure's well established role in disclosing clinical diagnostic inaccuracy.9 10 Many factors underlie this decline, but one of the most potent is likely to be the attitudes of both health care professionals and the general public. Other workers have studied the views of the general public,"'..5 embalmers and funeral directors,'6 17 medical students,'8-23 hospital clinicians,24 29 and pathologists.'5 30-32 Previous studies have examined the distribution of autopsy reports to general practitioners, the understanding that general practitioners have of their access to autopsy services and of which cases should be referred to the coroner, and general practitioners' overall views on autopsies.33.36 Our study concentrates on gen- eral practitioners' views on the utility of individual reports. Methods Reports on autopsies carried out by the adult autopsy service at Manchester Royal Infirmary are sent routinely to general practitioners. From 1 May to 30 October 1995, each was accompa- nied by a questionnaire, an explanatory letter, and a self-addressed return envelope. The questionnaire included a brief section on how the subject's death had been reported to the general practitioner, and a longer section on the characteristics of the report and the value of its content. A few questions on the respondent's views on autopsies in general were taken from a previous study.20 Some of the responses were made on closed categorical scales (tables 1-3), but most were made on five point Likert scales (tables 4 and 5). The last page of the question- naire was an open-ended invitation to comment on the content of any of the preceding closed questions. Numerical data was analysed with the software package SPSS (Chicago, Illinois, USA). The first 20 returns were intended to be a pilot study, but scrutiny of these revealed that there were no difficulties with the design of the study that required any remedy. Results Of 395 questionnaires sent out, 256 accompa- nied reports on patients who had died in the community and who were subjected to autopsy at the request of the coroner. Of the remaining 139 cases, 129 were coroner's autopsies carried out on patients who had died in hospital; only 10 were clinical interest autopsies, and none of these had been requested by general practition- ers. One hundred and thirty five (34.2%) were returned with usable data; eight more were returned blank because they had been sent to the wrong general practitioner, or because the patient's notes were no longer available, despite the fact that all these reports were sent out within three days of autopsy. The completed returns indicated that 24% of respondents had seen the patient during the last week of life, 32% in the last month, 30% in the last year, and 9% more than a year before death; 1 % could not remember and 4% did not respond to this question. Very few were present at 548 on June 13, 2020 by guest. Protected by copyright. http://jcp.bmj.com/ J Clin Pathol: first published as 10.1136/jcp.50.7.548 on 1 July 1997. Downloaded from