Table 1.

The medical autopsy: contributions to evidence-based medicine

Area	Comment
Understanding of diseases	Historically, autopsies form the basis of medical knowledge. Less acknowledged is the fact that autopsies remain essential for the follow-up of diseases, and for uncovering both common [52] and rare diseases, among others within the field of neuropathology (f.e. prion diseases [53], Alzheimer’s [54], multiple sclerosis [55]), infectious diseases (as Legionnaire’s disease [56], AIDS [57, 58], SARS [59], COVID-19 [60, 61]), collagen vascular disorders [62], to name a few
Quality control of clinical practice	Despite advances in laboratory medicine and diagnostic imaging, autopsies continue to reveal unsuspected, clinically important diagnoses in a significant number of deaths [63, 64]. Low autopsy rates may lead to an overestimation of clinical diagnostic performance [65]
Teaching of medical students, residents, physicians, and other healthcare staff	Besides pathology, pathological anatomy, topography, and pathophysiology, also clinicopathological correlations and observations are core skills learnt from autopsies [66]. The declining autopsy numbers raise concerns about future medical training, and the quality of diagnosis and medical treatment [67, 68]
Training in medical procedures	Training on corpses is an invaluable tool for rehearsal of complex anatomy for surgical procedures [69, 70]. The legal regulation of post-mortem clinical training practice is thus often included in autopsy legislations [71]
Quality control of public statistics	Being considered “gold standard” for cause of death, autopsy results are used for correction of public statistics [72]. Low autopsy rates worldwide endanger adequate distribution of funding of various diseases [73, 74]
Tissue sampling and research	Autopsies remain a major source for sampling of fluids, cells, and tissues. As a substitute for the full, conventional post-mortem, f.e. in cases of consensual problems, or in need for ultra-fresh sampling, minimally invasive procedures, and rapid research autopsy have been developed [75, 76]