Feasibility and validity of using death surveillance data and SmartVA for fact and cause of death in clinical trials in rural China: a substudy of the China salt substitute and stroke study (SSaSS)

2020 ◽  
pp. jech-2020-214063
Author(s):  
Liping Huang ◽  
Jie Yu ◽  
Bruce Neal ◽  
Yishu Liu ◽  
Xuejun Yin ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Causes Of Death ◽  
Rural China ◽  
Surveillance Data ◽  
Primary Data ◽  
Mortality Data ◽  
Face To Face ◽  
Stroke Study ◽  
Salt Substitute ◽  
Mortality Surveillance

BackgroundIn rural China, mortality surveillance data may be an alternative to primary data collection in clinical trials; SmartVA (verbal autopsy) is also a potential alternative for endpoint adjudication. The feasibility and validity of both need to be assessed.MethodsWe used mortality data from the first 24 months of the China Salt Substitute and Stroke Study (SSaSS) trial and assessed the agreement between (1) mortality surveillance data and face-to-face visits for fact of death; (2) mortality surveillance data and SSaSS adjudication for causes of death; (3) SmartVA and SSaSS adjudication for causes of death; (4) cause-specific mortality fraction of different methods. Face-to-face visits and SSaSS adjudication were taken as reference methods. The agreement was measured by sensitivity, specificity and positive predictive value (PPV) across different 10th Revision of International Statistical Classification of Diseases chapters.ResultsOne thousand three hundred and sixty-five deaths were included. Mortality surveillance data had 82% sensitivity for fact of death and 81% sensitivity for causes of death, with substantial variances across different disease types and reasonable quality for circulatory death (91% sensitivity and 94% PPV). The sensitivity of SmartVA for causes of death was 61%, with reasonable quality for deaths of external causes of morbidity (90% sensitivity). The leading causes of death from different sources were the same with some variances in the fractions.ConclusionUsing mortality surveillance data for fact of death in clinical trials need to account for under-reporting. A face-to-face visit to all participants at the completion of trials may be warranted. Neither mortality surveillance data nor SmartVA provided valid data source for endpoint events.

scholarly journals Excess mortality during COVID-19 in five European countries and a critique of mortality data analysis

2020 ◽  
Author(s):  
J. Félix-Cardoso ◽  
H. Vasconcelos ◽  
P. Pereira Rodrigues ◽  
R. Cruz-Correia
Keyword(s):  
Excess Mortality ◽  
Surveillance Data ◽  
European Countries ◽  
Mortality Data ◽  
Surveillance Systems ◽  
Policy Responses ◽  
Seasonal Time Series ◽  
And Gender ◽  
The Impact ◽  
Mortality Surveillance

AbstractINTRODUCTIONThe COVID-19 pandemic is an ongoing event disrupting lives, health systems, and economies worldwide. Clear data about the pandemic’s impact is lacking, namely regarding mortality. This work aims to study the impact of COVID-19 through the analysis of all-cause mortality data made available by different European countries, and to critique their mortality surveillance data.METHODSEuropean countries that had publicly available data about the number of deaths per day/week were selected (England and Wales, France, Italy, Netherlands and Portugal). Two different methods were selected to estimate the excess mortality due to COVID19: (DEV) deviation from the expected value from homologue periods, and (RSTS) remainder after seasonal time series decomposition. We estimate total, age- and gender-specific excess mortality. Furthermore, we compare different policy responses to COVID-19.RESULTSExcess mortality was found in all 5 countries, ranging from 10.6% in Portugal (DEV) to 98.5% in Italy (DEV). Furthermore, excess mortality is higher than COVID-attributed deaths in all 5 countries.DISCUSSIONThe impact of COVID-19 on mortality appears to be larger than officially attributed deaths, in varying degrees in different countries. Comparisons between countries would be useful, but large disparities in mortality surveillance data could not be overcome. Unreliable data, and even a lack of cause-specific mortality data undermine the understanding of the impact of policy choices on both direct and indirect deaths during COVID-19. European countries should invest more on mortality surveillance systems to improve the publicly available data.

A MODERN JUDICIAL SYSTEM IN INDONESIA: LEGAL BREAKTHROUGH OF E-COURT AND E-LEGAL PROCEEDING

2020 ◽  
Vol 9 (2) ◽  
pp. 275
Author(s):  
Dedi Putra
Keyword(s):  
Supreme Court ◽  
Secondary Data ◽  
Primary Data ◽  
Access To Justice ◽  
Judicial Reform ◽  
Legal Service ◽  
Literature Study ◽  
Face To Face ◽  
Legal Proceedings ◽  
Digital Era

The implementation of court in Indonesia has not fulfilled as expected because any parties involving in court has a lack of capacity, consistency, and integrity to provide legal service seriously. Some people assume that court services are not still optimal. To settle the problems, the Supreme Court just has officially issued Regulation No. 1 of 2019 regarding the Administration of Cases and Legal Proceedings in Courts via Electronic Means on 8 August 2019. This regulation is believed as an appropriate solution to face those problems. To elaborate more, this study illustrates a judicial reform in Indonesia, e-court, and access to justice, the conception of e-court including the performance of e-court and its drawbacks and challenges in the digital era. The research method uses normative research by approaching legal review and literature study. The technique of primary data collection applies Supreme Court regulation while means of secondary data are collected from concept or theory as set out under bibliography. Judicial reform in Indonesia is indicated by issuing new regulation regarding e-Court and e-Litigation, the implementation e-Court itself has been attributed to 32 courts consisting of general religious, and state administrative courts. Through e-Court, access to justice more transparent and accessible. Besides, justice seekers have no worries regarding distance issues as of e-Court may allow them to fight in court without face to face. Parties have no doubt relating to the acceleration of court to settle any dispute in Indonesia.

scholarly journals Investigation of ill-defined causes of death: assessment of a program's performance in a State from the Northeastern region of Brazil

2014 ◽  
Vol 17 (1) ◽  
pp. 119-134 ◽  
Author(s):  
Elisabeth Barboza França ◽  
Carolina Cândida da Cunha ◽  
Ana Maria Nogales Vasconcelos ◽  
Juan José Cortez Escalante ◽  
Daisy Xavier de Abreu ◽  
...  
Keyword(s):  
Health Professionals ◽  
Causes Of Death ◽  
Family Health ◽  
Completion Rate ◽  
Epidemiological Surveillance ◽  
Mortality Data ◽  
Hospital Records ◽  
Brazilian Government ◽  
Probabilistic Sample

OBJECTIVE: The proportion of ill-defined causes of death (IDCD) was persistently high in some regions of Brazil in 2004. In 2005, the Brazilian government implemented a project in order to decrease this proportion, especially in higher priority states and municipalities. This study aimed to evaluate the performance of this project in Alagoas - a state from the Northeast region of Brazil. METHOD: We selected a probabilistic sample of 18 municipalities. For all IDCD identified in 2010, we collected the verbal autopsy (VA) questionnaires used for home investigation, and the Ministry of Health (MoH) form, which contains information about the final disease and cause of death taken from hospital records, autopsies, family health teams, and civil registry office records. The completion rate of the MoH form and VA was calculated using the number of deaths with specific causes assigned among investigated deaths. RESULTS: A total of 681 IDCD were recorded in 2010 in the sample, of which 26% had a MoH and/or VA3 forms completed. Although the majority of cases were attended by health professionals during the terminal disease, the completion rate was 45% using the MoH form and 80% when VA was performed. CONCLUSIONS: Our findings provide evidence that the training of the epidemiological surveillance teams in the investigation and certification of causes of death could contribute to improve the quality of mortality data.

scholarly journals Sex disparities in cardiovascular health metrics among rural-dwelling older adults in China: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaolei Han ◽  
Ziying Jiang ◽  
Yuanjing Li ◽  
Yongxiang Wang ◽  
Yajun Liang ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Cardiovascular Health ◽  
Rural China ◽  
Descriptive Analysis ◽  
Population Based ◽  
Baseline Survey ◽  
Chinese Older Adults ◽  
Face To Face ◽  
Sex Disparities

Abstract Background Cardiovascular health (CVH) metrics among Chinese older adults are poorly understood. We investigated sex disparities in CVH metrics and their management among rural-dwelling older adults in China. Methods This community-based study included 5026 participants (age ≥ 65 years; 57.2% women) in the baseline survey of a multimodal intervention study in rural China. In March–September 2018, data were collected through face-to-face interviews, clinical examinations, and laboratory tests. We defined six CVH metrics (three behavioral factors—smoking, body mass index, and physical activity; three biological factors—blood pressure, total cholesterol, and blood glucose) following the modified American Heart Association’s recommendations. We performed descriptive analysis separately for men and women. Results Of all participants, only 0.8% achieved ideal levels in all six CVH metrics. Men were more likely than women to have ideal levels in all CVH metrics but smoking. Women had higher prevalence of ideal global (9.7% vs. 7.8%) and behavioral (18.3% vs. 9.5%) CVH metrics (p < 0.001), whereas men had higher prevalence of ideal biological CVH metrics (5.4% vs. 3.5%, p < 0.001). The prevalence of ideal global and behavioral CVH metrics increased with age in both women and men (p for trend< 0.001). Women were more likely to be aware of their hypertension and diabetes, and to receive antihypertensive treatment, while men were more likely to achieve the goal of high cholesterol treatment (p < 0.05). Conclusions The CVH metrics among older adults living in the rural communities in China are characterized by an extremely low proportion of optimal global CVH metrics and distinct sex differences, alongside poor management of major biological risk factors. Trial registration ChiCTR1800017758 (Aug 13, 2018).

scholarly journals Mortality beyond emergency threshold in a silent crisis– results from a population-based mortality survey in Ouaka prefecture, Central African Republic, 2020

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eve Robinson ◽  
Lawrence Lee ◽  
Leslie F. Roberts ◽  
Aurelie Poelhekke ◽  
Xavier Charles ◽  
...  
Keyword(s):  
Central African Republic ◽  
Causes Of Death ◽  
Maternal Mortality Ratio ◽  
Mortality Rates ◽  
Population Based ◽  
Access To Healthcare ◽  
Mortality Data ◽  
Humanitarian Emergency ◽  
The World ◽  
Mortality Survey

Abstract Background The Central African Republic (CAR) suffers a protracted conflict and has the second lowest human development index in the world. Available mortality estimates vary and differ in methodology. We undertook a retrospective mortality study in the Ouaka prefecture to obtain reliable mortality data. Methods We conducted a population-based two-stage cluster survey from 9 March to 9 April, 2020 in Ouaka prefecture. We aimed to include 64 clusters of 12 households for a required sample size of 3636 persons. We assigned clusters to communes proportional to population size and then used systematic random sampling to identify cluster starting points from a dataset of buildings in each commune. In addition to the mortality survey questions, we included an open question on challenges faced by the household. Results We completed 50 clusters with 591 participating households including 4000 household members on the interview day. The median household size was 7 (interquartile range (IQR): 4—9). The median age was 12 (IQR: 5—27). The birth rate was 59.0/1000 population (95% confidence interval (95%-CI): 51.7—67.4). The crude and under-five mortality rates (CMR & U5MR) were 1.33 (95%-CI: 1.09—1.61) and 1.87 (95%-CI: 1.37–2.54) deaths/10,000 persons/day, respectively. The most common specified causes of death were malaria/fever (16.0%; 95%-CI: 11.0–22.7), violence (13.2%; 95%-CI: 6.3–25.5), diarrhoea/vomiting (10.6%; 95%-CI: 6.2–17.5), and respiratory infections (8.4%; 95%-CI: 4.6–14.8). The maternal mortality ratio (MMR) was 2525/100,000 live births (95%-CI: 825—5794). Challenges reported by households included health problems and access to healthcare, high number of deaths, lack of potable water, insufficient means of subsistence, food insecurity and violence. Conclusions The CMR, U5MR and MMR exceed previous estimates, and the CMR exceeds the humanitarian emergency threshold. Violence is a major threat to life, and to physical and mental wellbeing. Other causes of death speak to poor living conditions and poor access to healthcare and preventive measures, corroborated by the challenges reported by households. Many areas of CAR face similar challenges to Ouaka. If these results were generalisable across CAR, the country would suffer one of the highest mortality rates in the world, a reminder that the longstanding “silent crisis” continues.

scholarly journals The decomposition of life expectancy for age and cause of death in Tuscany, Italy

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Nante ◽  
L Kundisova ◽  
F Gori ◽  
A Martini ◽  
F Battisti ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
National Level ◽  
Age Groups ◽  
Resistant Bacteria ◽  
Mortality Data ◽  
Life Expectancy At Birth ◽  
Icd 10 ◽  
Reduction Of Mortality ◽  
The Impact

Abstract Introduction Changing of life expectancy at birth (LE) over time reflects variations of mortality rates of a certain population. Italy is amongst the countries with the highest LE, Tuscany ranks fifth at the national level. The aim of the present work was to evaluate the impact of various causes of death in different age groups on the change in LE in the Tuscany region (Italy) during period 1987-2015. Material and methods Mortality data relative to residents that died during the period between 1987/1989 and 2013/2015 were provided by the Tuscan Regional Mortality Registry. The causes of death taken into consideration were cardiovascular (CVS), respiratory (RESP) and infective (INF) diseases and cancer (TUM). The decomposition of LE gain was realized with software Epidat, using the Pollard’s method. Results The overall LE gain during the period between two three-years periods was 6.7 years for males, with a major gain between 65-89, and 4.5 years for females, mainly improved between 75-89, &lt;1 year for both sexes. The major gain (2.6 years) was attributable to the reduction of mortality for CVS, followed by TUM (1.76 in males and 0.83 in females) and RESP (0.4 in males; 0.1 in females). The major loss of years of LE was attributable to INF (-0.15 in females; -0.07 in males) and lung cancer in females (-0.13), for which the opposite result was observed for males (gain of 0.62 years of LE). Conclusions During the study period (1987-2015) the gain in LE was major for males. To the reduction of mortality for CVS have contributed to the tempestuous treatment of acute CVS events and secondary CVS prevention. For TUM the result is attributable to the adherence of population to oncologic screening programmes. The excess of mortality for INF that lead to the loss of LE can be attributed to the passage from ICD-9 to ICD-10 in 2003 (higher sensibility of ICD-10) and to the diffusion of multi-drug resistant bacteria, which lead to elevated mortality in these years. Key messages The gain in LE during the period the 1987-2015 was higher in males. The major contribution to gain in LE was due to a reduction of mortality for CVS diseases.

scholarly journals Marketing of orange: a value chain perspective in the selected areas of Sylhet District in Bangladesh

2016 ◽  
Vol 27 (3) ◽  
pp. 327-338
Author(s):  
M Begum ◽  
MR Ahmed ◽  
T Noor ◽  
MI Hossain
Keyword(s):  
Value Chain ◽  
Simple Random Sampling ◽  
Primary Data ◽  
Cash Income ◽  
Fruit Crops ◽  
Value Addition ◽  
Face To Face ◽  
Interview Technique ◽  
A Value ◽  
Structured Questionnaire

Orange is one of the most import fruit crops that generate additional cash income for market actors. The study was investigated the marketing system of orange , value addition, roles and functions of value chain actors with the help of primary data collected from both farmers (forty) through simple random sampling and value chain actors (thirty) through purposive sampling by using structured questionnaire and face to face interview technique. The gross return and net return of farmers were estimated Tk. 2, 70,000 and Tk. 22084.77 per hectare respectively. Per quintal value addition of orange of bepari, aratdar, wholesaler and retailer were estimated at Tk. 800, Tk. 340, Tk. 700 and Tk. 1000 respectively. The net marketing margin per quintal of orange of bepari, aratdar, wholesaler and retailer were estimated at Tk. 293.59, Tk. 107.32, Tk. 356.46 and Tk. 700.8 respectively. Among the different actors, retailer incurred highest (in percentage) value addition and net marketing margin. On the other hand, aratdar incurred lowest marketing cost and marketing margin and bepari incurred highest (in percentage) marketing cost but adding second highest value in compare to another.Progressive Agriculture 27 (3): 327-338, 2016

scholarly journals Core outcome set measurement for future clinical trials in acute myeloid leukemia: the HARMONY study protocol using a multi-stakeholder consensus-based Delphi process and a final consensus meeting

2020 ◽  
Author(s):  
Katharina M Lang ◽  
Kathryn L. Harrison ◽  
Paula R. Williamson ◽  
Brian J.P. Huntly ◽  
Gert Ossenkoppele ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Core Outcome Set ◽  
Core Outcome ◽  
Face To Face ◽  
Outcome Set ◽  
Multi Stakeholder ◽  
Stakeholder Consensus ◽  
Acute Myeloid

Abstract Background Acute myeloid leukemia is the most common acute leukemia in adults with an unacceptably low cure rate. In recent years a number of new treatment strategies and compounds were developed for the treatment of acute myeloid leukemia. There were several randomized, controlled clinical trials with the objective to improve patients’ management and patients’ outcome in acute myeloid leukemia. Unfortunately, these trials are not always directly comparable, as they do not measure the same outcomes and currently there are no core outcome sets that can be utilized to guide outcome selection and harmonization in this disease area. The HARMONY Alliance is a public-private European Network established in 2017, which currently includes 53 partners and 32 associated members from 22 countries. Amongst many other goals of the HARMONY Alliance, Work Package 2 focuses on defining outcomes that are relevant to each hematological malignancy. In accordance, a pilot study will be performed to define core outcome set in acute myeloid leukemia. Methods The pilot study will use a three-round Delphi survey and a final consensus meeting to define a core outcome set. Participants will be recruited from different stakeholder groups, including patients, clinicians, regulators and members of the European Federation of Pharmaceutical Industries and Associations (EFPIA). At the pre-Delphi stage a literature research was conducted followed by several semi-structured interviews of clinical public and private key opinion leaders. Subsequently the preliminary outcome list was discussed in several multi-stakeholder face-to-face meetings. The Delphi survey will reduce the preliminary outcome list to essential core outcomes. After completing the last Delphi round a final face-to-face meeting is planned to achieve consensus about core outcome set in acute myeloid leukemia. Discussion The pilot Delphi as part of HARMONY Alliance aims to define a core outcome set in acute myeloid leukemia based on a multi-stakeholder consensus. Such a core outcome set will help to allow consistent comparison of future clinical trials and real world evidence research and ensures that appropriate outcomes valued by a range of stakeholders are measured within future trials.

scholarly journals Factors Determining the Effective Role of Microfinance

2015 ◽  
Vol 1 (2) ◽  
pp. 129-141
Author(s):  
Shahina Imran ◽  
Rana M Imran Arshad
Keyword(s):  
Household Head ◽  
Institutional Factors ◽  
Primary Data ◽  
Economic Empowerment ◽  
Business Activity ◽  
Business Training ◽  
Face To Face ◽  
Effective Role ◽  
Head Area

The focus of this study is on the effectiveness of economic, social and institutional factors in manipulating the role of microfinance. It is a primary data research conducted in the Bahawalpur division, Pakistan. The sample consists of 773 respondents, belonging to different microfinance providers of Pakistan that are NRSP, AKHU, FMFB,  KASHF, KB, NRSP-B, TMFB. Data has been collected through face to face structured interviewing using a questionnaire. It has been found that economic wellbeing and economic empowerment of borrowers after availing microfinance is positively affected by consumer protection, education of borrowers, experience, business training, number of employed persons, length of membership, relation to household head, area and family reaction to business activity but negatively by diversion of loan, interest rate, age of the borrowers and number of dependents.

scholarly journals Human 2.0: Behavioral Dissonance between Online and Offline Personal Traits, And Implications on e-Marketing Practices

2021 ◽  
Vol 3 (2) ◽  
pp. 18-25
Author(s):  
Moataz Kamel
Keyword(s):  
User Interfaces ◽  
Online Advertising ◽  
Primary Data ◽  
Business Practices ◽  
Computer User ◽  
Personal Traits ◽  
Face To Face ◽  
Internet Users ◽  
Primary Data Analysis ◽  
The Social

This research paper presents an attempt to explore the phenomenon of a consistent disconnection between the online and offline personality traits of Internet users. The research delves deeper into this notion, explores the possible drivers and stimulants, and then puts special emphasis on its implications and repercussions on various business aspects, such as online advertising and e-marketing techniques. The research uses a variety of instruments and tools, including structured observations, face-to-face interviews, online surveys, and mock computer User Interfaces designed specifically for the purpose of the experiments conducted as part of the primary data collection for the research. The paper then proceeds to analyze the primary data and presents an attempt to understand the phenomenon and its underlying stimulants. Finally, the paper presents a set of conclusions, again with more focus on marketing and business-related issues. The research, through its primary data analysis and rationalization, concludes that there is strong evidence that most internet users exhibit different facets of behavioral dissonance between their online and offline traits. The research also concludes that such dissonance may be induced by the social internet ecosystem and dynamics, rather than intrinsic tendencies in the users’ actual characters. The research also relates these findings with common business practices of successful online businesses and sheds the light on potential ethical dilemmas pertaining to internet businesses exploiting these phenomena (albeit sometimes unknowingly) to lure their users into buying products or to generate more traffic.

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