15283-B-Blokker

81 Agreement between MIA and CA: a cross-sectional study 5 INTRODUCTION Conventional autopsy (CA) is a valuable tool, particularly for quality control in healthcare. 9,13,15 Nevertheless, autopsy rates have been rapidly declining, 22,23,46 One of the reasons is reluctance of clinicians to request and unwillingness of next-of- kin to consent to autopsy, because of fear for mutilation of the deceased’s body or organ retention. 22,24,38,81 Hence, non-invasive or minimally invasive alternative autopsy methods are being developed. 56 Using post - mortem CT (PMCT) and MRI (PMMR), the entire body can be visualized 59,102,104 and, with minimal damage to the body, image - guided tissue biopsies can be obtained for histological examination. 57 In addition post-mortem CT-angiography (CTA) can be performed. 80,108,109,132-135 Some of these methods are already used to support or even substitute the forensic autopsy. 48,97 In the clinical setting, non-invasiveorminimally invasive autopsies of fetuses, newborns and infants 136 have gained acceptance with parents and physicians, and political and public interest. 137 However, they are still rarely applied in adult patients. The main aim of this study was to compare cause of death (COD) established with CA and minimally invasive autopsy (MIA) in adults deceased in a clinical setting, under the a priori hypothesis that MIA and CA would perform equally well. METHODS Study Design We performed a prospective, single center, cross-sectional study in an academic hospital comparing diagnostic performance of MIA and CA. The institutional review board approved of the study prior to data collection. MIA was followed by CA on the same case. Those involved in MIA and CA were blinded to each other. Primary outcome measure: performance in establishing cause of death (COD) by MIA and CA. Secondary outcome measures: diagnostic yield for all diagnoses, major diagnoses and grouped major diagnoses (GMD); frequency of clinically unsuspected findings; percentage of answered specific clinical questions. Participants From January 2012 through December 2014 all hospitalized patients aged 18 years and older who died at Erasmus University Medical Center were eligible, if written informed consent was obtained from next-of-kin for MIA and CA.