A PROTOTYPE INTERNET AUTOPSY DATABASE - 1625 CONSECUTIVE FETAL AND NEONATAL AUTOPSY FACESHEETS SPANNING 20 YEARS

Objective.-To demonstrate that cause-of-death statements can be genera ted by a computer algorithm from an autopsy database composed of diagn ostic terms, Data Sources.-Over 49 000 autopsy facesheets contributed by over a dozen institutions were collected from a publicly accessible Internet autopsy database. This database is available at the followin g web site: http:// www.med.jhu.edu/pathology/iad.html Study Selection .-To test the feasibility of creating and using a publicly available a utopsy database, and to identify the technical and medicolegal problem s that may arise with such a novel resource, a prototype study was des igned by selecting autopsy facesheets from fetal and neonatal deaths. An algorithm was developed to determine the cause of death from the li sting of anatomic diagnoses. Data Extraction.-One thousand six hundred twenty-five fetal and neonatal autopsy facesheets were selected encom passing fetal and neonatal deaths occurring up to 28 days after birth. Data Synthesis.-The algorithm determined causes of death from autopsy facesheet data in all cases. On review by an experienced pediatric pa thologist, these automatically generated cause-of-death statements req uired no modification or only slight modification in over 90% of cases . Conclusions.-A large multi-institutional autopsy database composed o f demographic and diagnostic information has been deposited on the Int ernet, This information can be freely downloaded acid used by any rese archer without violating patient confidentiality. As a demonstration o f one possible application of the database, fetal and neonatal autopsi es generated cause-of-death statements using a computer algorithm. One can anticipate that the wealth of information contained in autopsy fa cesheets can be assembled into a database that will serve the public i nterest.