Background: Globally, autopsy rates have been continually declining over the course of several years. Previous studies have shown that the perception of pathologists and clinicians may serve as significant factors which may affect the performance of autopsy and contribute to its decreased rate. This study was conducted to determine the attitudes and perceptions of Filipino clinicians and pathologists toward the autopsy as a medical tool. Methodology: This is a cross-sectional descriptive survey of two groups of physicians. Forty-four (n = 44) pathologists nationwide and thirty-three (n = 33) clinicians from Central Visayas participated in the study. A total of seventy-seven (n = 77) physicians completed a survey using a standardized online questionnaire. Results: Of the 77 respondents, 94% of clinicians and 75% of pathologists believed that autopsies could provide relevant findings that could change future clinical practice. Despite this, only 6% of clinicians and 20% of pathologists indicated that the number of autopsy cases in their institutions was sufficient. With regards to their practice, pathologists most strongly agreed (mean = 4.30) that material for medico-legal autopsies should be readily available for teaching and research. However, they most strongly disagreed (mean = 2.00) that residents receive adequate training in performing medico-legal autopsies. The two groups of physicians surveyed determined that there is a deficiency in the number of autopsy cases. This is further influenced by clinicians’ concerns about litigation, religious/superstitious beliefs, and the delay in releasing autopsy results. Furthermore, pathologists specified that performing autopsies was excessively time-consuming with an unjustifiable cost. Sixty-two percent of the pathologists signified more strongly than the clinicians that modern diagnostic techniques have diminished the need to perform hospital autopsies. Nonetheless, 86% of Filipino physicians acknowledged that the autopsy is an important medical tool that should be performed for patients with unknown diagnoses and unexpected death. The number of observed and/or performed autopsy cases was a major factor that affected the pathologists’ attitudes and perceptions toward autopsy. Conclusion In general, there is recognition of the autopsy’s usefulness as a medical tool among the pathologists and clinicians surveyed. However, the lack of cases referred for autopsy remains a challenge undermining the benefits that are derived from its performance.
Autopsy ; Pathologists ; Attitude

Objective: The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios. Methodology: The primary search was done through search in electronic databases. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Eligible studies were appraised using well-defined criteria. Results: The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). Conclusion The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. It is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.
Mean Platelet Volume ; Myocardial Infarction ; Chest Pain