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A Goldman class I discrepancy is a missed major diagnosis in which the principle, underlying causes of death was missed with probable adverse impact on survival.
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Opportunistic infections accounted for the majority (67%) of class I discrepancies.
In patients with class I discrepancies the most frequently missed diagnosis was myocardial infarction.
Shown are the findings in the 10 patients with class I discrepancies.
Class I discrepancies were due to opportunistic infections (67%) and cardiac complications (33%), whereas class II discrepancies were due to cardiopulmonary complications (70%) and opportunistic infections (30%).
Of the 86 patients, 22 (26%) had 25 major missed diagnoses, 12 (54%) patients had class I discrepancies, 7 (32%) had class II discrepancies, and 3 (14%) had both class I and class II discrepancies.
Major missed diagnoses (discordant cases) were noted in 22 patients (26%) (group 1): 12 (54%) patients had class I discrepancies, 7 (32%) had class II discrepancies, and 3 (14%) had both class I and class II discrepancies.
Class I discrepancies were defined as a missed major diagnosis that, had it been made, would have changed management and might have resulted in prolonged survival.
Class I discrepancies represent major missed diagnoses in which knowledge of the postmortem findings might have altered treatment and/or prolonged survival.
Opportunistic infections were the most common class I discrepancies, followed by cardiac complications (thrombotic endocarditis, myocardial infarction, and heart failure) (Table 2).
As mentioned in the section for Model I, discrepancies between theory and simulation are generally found to decrease with increasing K M ; for the case of competitive inhibition, the effective K M of the reaction is significantly larger than that of the enzyme (see Eq. (11)), which explains the increased agreement between theory and simulations for Model III compared to the previous two models.
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