scholarly journals Mortality and quality of death certification in a cohort of patients with Parkinson’s disease and matched controls in North Wales, UK at 18 years: a community-based cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018969 ◽  
Author(s):  
Peter Hobson ◽  
Jolyon Meara
Keyword(s):  
Parkinson’S Disease ◽  
Cause Of Death ◽  
Death Certificates ◽  
Death Certification ◽  
Community Based ◽  
Risk Of Mortality ◽  
North Wales ◽  
Quality Of Death ◽  
Underlying Cause Of Death

ObjectiveThis investigation reports the cause and the quality of death certification in a community cohort of patients with Parkinson’s disease (PD) and controls at 18 years.SettingDenbighshire North Wales, UK.ParticipantsThe community-based cohorts consisted of 166 patients with PD and 102 matched controls.Primary outcomesAll-cause mortality was ascertained at 18 years by review of hospitals’ primary care records and examination of death certificates obtained from the UK General Register Office. Mortality HRs were estimated using Cox proportional regression, controlling for covariates including age at study entry, age at death, gender, motor function, mood, health-related quality of life (HRQoL) and cognitive function.ResultsAfter 18 years, 158 (95%) of patients in the PD cohort and 34 (33%) in the control cohort had died. Compared with the general UK population, the PD cohort had a higher risk of mortality (standard mortality rate, 1.82, 95% CI 1.55 to 2.13). As the primary or underlying cause of death, PD was not reported in 75/158 (47%) of the death certificates. In addition, although 144/158 (91%) of the PD cohort had a diagnosis of dementia, this was reported in less than 10% of death certificates. The main cause of death reported in the PD cohort was pneumonia (53%), followed by cardiac-related deaths (21%). Compared with controls, patients with PD had a greater risk of pneumonia (2.03, 95% CI 1.34 to 3.6), poorer HRQoL and more likely to reside in institutional care at death (P<0.01).ConclusionThis investigation found that PD was associated with an excess risk of mortality compared with the general population. However, PD as a primary or underlying cause of death recorded on certificates was found to be suboptimal. This suggests that the quality of mortality statistics drawn from death certificates alone is not a valid or reliable source of data.

scholarly journals Assessing quality of medical death certification: Concordance between gold standard diagnosis and underlying cause of death in selected Mexican hospitals

2011 ◽  
Vol 9 (1) ◽  
Author(s):  
Bernardo Hernández ◽  
Dolores Ramírez-Villalobos ◽  
Minerva Romero ◽  
Sara Gómez ◽  
Charles Atkinson ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Gold Standard ◽  
Death Certification ◽  
Underlying Cause Of Death

scholarly journals Death certification in a psychiatric hospital

1998 ◽  
Vol 22 (10) ◽  
pp. 624-629
Author(s):  
Emad Salib
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Hospital ◽  
No Value ◽  
Retrospective Review ◽  
Chronic Conditions ◽  
Clinical Implications ◽  
Death Certificates ◽  
Death Certification ◽  
Quality Of Death

Aims and methodA retrospective review of death certificates issued at a large psychiatric hospital in North Cheshire during the 1980s and 1990s.ResultsDementia, which was the recorded clinical diagnosis in 78% of all deceased, was reported in 31% of death certificates, while other psychiatric disorders (22% of all deceased) appeared in only 2% of certificates. Autopsy appears to have very little or no value in improving the quality of death certificates in psychiatry.Clinical implicationsThe onus is on the clinicians to produce adequate death certificates. Recording chronic conditions present at death, such as dementia and other psychiatric disorders, in addition to those directly causing or contributing to death would improve the epidemiological value of death certificates.

scholarly journals Improving cause of death certification in the Philippines: implementation of an electronic verbal autopsy decision support tool (SmartVA auto-analyse) to aid physician diagnoses of out-of-facility deaths

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rohina Joshi ◽  
R. H. Hazard ◽  
Pasyodun Koralage Buddhika Mahesh ◽  
L. Mikkelsen ◽  
F. Avelino ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Medical Records ◽  
Causes Of Death ◽  
Decision Support Tool ◽  
The Philippines ◽  
Death Certification ◽  
Group Discussions ◽  
Support Tool ◽  
Quality Of Death

Abstract Background The majority of deaths in the Philippines occur out-of-facility and require a medical certificate of cause of death by Municipal Health Officers (MHOs) for burial. MHOs lack a standardised certification process for out-of-facility deaths and when no medical records are available, certify a high proportion of ill-defined causes of death. We aimed to develop and introduce SmartVA Auto-Analyse, a verbal autopsy (VA) based electronic decision support tool in order to assist the MHOs in certifying out-of-facility deaths. Method We conducted a stakeholder consultation, process mapping and a pre-test to assess feasibility and acceptability of SmartVA Auto-Analyse. MHOs were first asked to conduct an open-ended interview from the family members of the deceased, and if they were not able to arrive at a diagnosis, continue the interview using the standardised SmartVA questionnaire. Auto-Analyse then presented the MHO with the three most likely causes of death. For the pilot, the intervention was scaled-up to 91 municipalities. We performed a mixed-methods evaluation using the cause of death data and group discussions with the MHOs. Results Of the 5649 deaths registered, Auto-Analyse was used to certify 4586 (81%). For the remaining 19%, doctors believed they could assign a cause of death based on the availability of medical records and the VA open narrative. When used, physicians used the Auto-Analyse diagnosis in 85% of cases to certify the cause of death. Only 13% of the deaths under the intervention had an undetermined cause of death. Group discussions identified two themes: Auto-Analyse standardized the certification of home deaths and assisted the MHOs to improve the quality of death certification. Conclusion Standardized VA combined with physician diagnosis using the SmartVA Auto-Analyse support tool was readily used by MHOs in the Philippines and can improve the quality of death certification of home deaths.

scholarly journals Unmasking Parkinson’s Disease: The Relationship of Grit, Exercise, and Quality of Life

2020 ◽  
Vol 7 (6) ◽  
pp. 1732-1739
Author(s):  
Susan G Klappa ◽  
Julie A I Thompson ◽  
Stuart Blatt
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Support Groups ◽  
Physical Therapists ◽  
The United States ◽  
Community Based ◽  
Coping Responses ◽  
Home Based

The purpose of this study was to investigate grit, exercise, and quality of life (QOL) among individuals diagnosed with Parkinson’s disease (PD). A sample of convenience was used. A survey which included the grit scale, QOL scale, and open-ended questions was distributed to participants (n = 101, 51 male and 50 female) who are members of online PD support groups across the United States. Data were analyzed by SPSS 25. Grit values averaged 3.65 ± 0.51 for participants (n = 101). When divided into groups, mean grit score for community-based exercisers was 3.78 ± 0.42 and 3.10 ± 0.48 for home-based exercisers. Grit was positively correlated to higher QOL on the Parkinson’s disease quality of life (PDQL; r = +0.293, P = .004). Grit was positively correlated to the emotional component of the PDQL ( r = +0.462, P < .001). Participants with higher grit levels had higher emotional coping responses after being diagnosed with PD, exercised more, and were more willing to self-advocate. With limited rehabilitation visits allowed, physical therapists should be aware of community-based programs to redefine participation roles after diagnosis.

scholarly journals Quality of death certificates in Valencia, Spain.

1989 ◽  
Vol 79 (10) ◽  
pp. 1352-1354 ◽  
Author(s):  
F G Benavides ◽  
F Bolumar ◽  
R Peris
Keyword(s):  
Death Certificates ◽  
Quality Of Death

scholarly journals Querying of Death Certificates in the United States

2005 ◽  
Vol 120 (3) ◽  
pp. 288-293 ◽  
Author(s):  
Donna L. Hoyert ◽  
Ann R. Lima
Keyword(s):  
United States ◽  
New York ◽  
Incomplete Information ◽  
Cause Of Death ◽  
The United States ◽  
Death Certificates ◽  
Death Rates ◽  
Underlying Cause Of Death ◽  
The Impact ◽  
Registration Area

Objective. Data from death certificates are often used in research; however, little has been published on the processing of vague or incomplete information reported on certificates. The goal of this study was to examine the querying efforts in the United States used to clarify such records. Methods. The authors obtained data on the querying efforts of the 50 states, New York City, and the District of Columbia. Descriptive statistics are presented for two units of analysis: registration area and death record. Using data from a single registration area, Washington State, the authors compared the percent change in age-adjusted death rates for data from before and after querying to analyze the effect of querying on selected causes of death. Results. Fifty-one of the 52 registration areas queried either demographic or cause-of-death information. Almost 90% of queries were returned; the underlying cause of death changed in approximately 68% of these records. This data translates into about 3% of total U.S. death records, given that 4% of total U.S. death records were queried about cause of death. The impact of queries on age-adjusted death rates varied by cause of death. Generally, the effect is most obvious for cause-of-death categories that are specific and relatively homogenous. Conclusion. Querying continues to be widely practiced. In the case of cause-of-death queries, this method refines the assigned underlying cause of death for records reported with vague or incomplete information.

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