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J. Douglas White, MD
Georgetown University Hospital Washington, DC

JAMA. 1984;251(17):2207-2208.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I read the article by Zarling et al with great interest. Several conclusions, however, seem overdrawn, lacking either clinical or statistical significance.

The autopsy rate at the hospital studied (in excess of 20% ) seems high, particularly in the context of several articles and an editorial in the same issue suggesting much lower rates as the norm. In conjunction with the retrospective study design, this high rate suggests that the investigator may have selected out suspicious or perplexing deaths to examine. In the absence of a prospective and randomized protocol, I am less certain than the authors that this study has shown the way to improved prospective diagnosis.

The abstract states that noninternists and noncardiologists were more likely to miss this diagnosis, and the conclusion states that cardiologists demonstrated greater accuracy in their diagnostic acumen. The latter statement is not supported by the data, and the former statement . . . [Full Text PDF of this Article]

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