Background. Correctly and comprehensively formul ated diagnosis is a key to successful treatment strategy. Recent research data and methods change the clinical thinking of physicians and, in the same time, formulation features of diagnoses. Discrepancies between forensic medical and clinical diagnoses ranging from 14% to 49%, which could be reduced at a closer mutual cooperation between clinical and forensic doctors.
Aim. To determine the frequency of deontological expertises, discrepancies between forensic medical and clinical diagnoses on which an expertise was imposed.
Material and methods. In the State Forensic Medicine Service under the Ministry of Justice of the Republic of Lithuania conducted a retrospective analysis of the data, examining deontological expertises of the dead and living persons of 1984-2003, which have been designated for a possible discrepancy of diagnoses. Cases of the discrepancy between clinical diagnoses established by doctors and the forensic medical diagnoses were analysed. Discrepancies between diagnoses are classified into two categories: full mismatch and partial mismatch.
Results. 395 deontological expertises were analysed. They were carried out during the years 1984 to 2003: 37% of forensic medical and clinical diagnosis did not coincide, 24% partial match, 37% match and 2% was underrated. The highest frequency of diagnoses mismatch was between 2000 and 2002, of which 76% was allocated to the patient's death case. Majority cases (23%) were the patients treated in resuscitation intensive care units. In the period of 1984-2003 mainly complaints about the poor quality of treatment received by surgeons -13.42%, obstetricians gynecologists -8.1%, neurosurgeons - 7.34%.
Conclusions. In about 30% of the discrepancies between the clinical diagnosis and forensic medical diagnoses, an autopsy remains the gold standard, helping to improve the clinical diagnosis, determining the cause of death, comorbidities and concomitant status.
Keywords: forensic medical diagnosis, clinical diagnosis, deontological expertises, discrepancies between diagnoses.
