In-Vivo and Post-Mortem Gallstones: Support for Validity of the “Epidemiologic Necropsy” Screening Technique

This research was done to evaluate the “epidemiologic necropsy” procedure as a “screening” technique for disease that has been clinically unsuspected or inactive during life. The post-mortem occurrence rates of gallstones in necropsies at Yale-New Haven Hospital were compared and found reasonably si...

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Bibliographic Details
Published in:American journal of epidemiology 1991-05, Vol.133 (9), p.922-931
Main Authors: Simonovis, Nelson J. F., Wells, Carolyn K, Feinstein, Alvan R.
Format: Article
Language:English
Subjects:
Adult
Aged
Autopsy
Biological and medical sciences
cholelithiasis
Cholelithiasis - classification
Cholelithiasis - diagnostic imaging
Cholelithiasis - epidemiology
Continental Population Groups
Denmark - epidemiology
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Incidence
Italy - epidemiology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Mass Screening - methods
Mass Screening - standards
Medical sciences
Meta-Analysis as Topic
Middle Aged
necropsy
Other diseases. Semiology
Reproducibility of Results
screening
ultrasonic diagnosis
Ultrasonography
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Summary:This research was done to evaluate the “epidemiologic necropsy” procedure as a “screening” technique for disease that has been clinically unsuspected or inactive during life. The post-mortem occurrence rates of gallstones in necropsies at Yale-New Haven Hospital were compared and found reasonably similar to the analogous rates of gallstones detected in-vivo via ultrasonographic screening of large general populations. Because the authors could not find an appropriate in-vivo screening study done in the United States, they used data mainly from screening studies in Copenhagen, Denmark, and Rome and Sirmione, Italy. Two additional ultrasonographic screening studies have been done in Norway and in populations of Hispanic Americans Previous disparities between post-mortem and in-vivo screening results probably arose because of failure to stratify for age and sex, to remove patients with cholecystectomy from the analysis, or to account for small-size stones that would be detected at necropsy but not with ultrasonography The current results help confirm the value of the epidemiologic necropsy procedure in estimating the size of the substantial reservoir of undetected disease that does not appear in the customary tabulations of “vital statistics.” Am J Epidemiol 1991; 133: 922–31
ISSN:0002-9262
1476-6256
DOI:10.1093/oxfordjournals.aje.a115971