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Lawrence K. Altman, MD
New York Times

JAMA. 1984;251(17):2208-2209.

	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.—

Reports on the declining autopsy rates and failure to diagnose myocardial infarctions may have even greater implications beyond those stated in the Sept 2 issue of THE JOURNAL.

The decline in autopsies began in 1965.¹ The decline in cardiovascular mortality began in 1968.² The near-simultaneous occurrence of these two phenomena raises a crucial question: To what extent, if any, has the declining autopsy rate contributed to the decrease in cardiovascular mortality figures? Errors of diagnosis in myocardial infarction could affect the decline in cardiovascular death rates in either direction, depending on the cause of death cited in the misdiagnosed cases. Unfortunately, such data were not included in the article by Zarling et al. The methodology used in the Memphis study makes it impossible to determine the validity of the results in other American hospitals.

It would be important to rule out the decline in autopsies . . . [Full Text PDF of this Article]

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