scholarly journals The impact of errors in medical certification on the accuracy of the underlying cause of death

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259667
Author(s):  
U. S. H. Gamage ◽  
Tim Adair ◽  
Lene Mikkelsen ◽  
Pasyodun Koralage Buddhika Mahesh ◽  
John Hart ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Death Certificate ◽  
International Classification Of Diseases ◽  
High Impact ◽  
Error Type ◽  
Medical Certification ◽  
Underlying Cause Of Death ◽  
The Impact ◽  
Very High ◽  
Death Data

Background Correct certification of cause of death by physicians (i.e. completing the medical certificate of cause of death or MCCOD) and correct coding according to International Classification of Diseases (ICD) rules are essential to produce quality mortality statistics to inform health policy. Despite clear guidelines, errors in medical certification are common. This study objectively measures the impact of different medical certification errors upon the selection of the underlying cause of death. Methods A sample of 1592 error-free MCCODs were selected from the 2017 United States multiple cause of death data. The ten most common types of errors in completing the MCCOD (according to published studies) were individually simulated on the error-free MCCODs. After each simulation, the MCCODs were coded using Iris automated mortality coding software. Chance-corrected concordance (CCC) was used to measure the impact of certification errors on the underlying cause of death. Weights for each error type and Socio-demographic Index (SDI) group (representing different mortality conditions) were calculated from the CCC and categorised (very high, high, medium and low) to describe their effect on cause of death accuracy. Findings The only very high impact error type was reporting an ill-defined condition as the underlying cause of death. High impact errors were found to be reporting competing causes in Part 1 [of the death certificate] and illegibility, with medium impact errors being reporting underlying cause in Part 2 [of the death certificate], incorrect or absent time intervals and reporting contributory causes in Part 1, and low impact errors comprising multiple causes per line and incorrect sequence. There was only small difference in error importance between SDI groups. Conclusions Reporting an ill-defined condition as the underlying cause of death can seriously affect the coding outcome, while other certification errors were mitigated through the correct application of mortality coding rules. Training of physicians in not reporting ill-defined conditions on the MCCOD and mortality coders in correct coding practices and using Iris should be important components of national strategies to improve cause of death data quality.

A haláloki diagnózisok megbízhatóságának javítása a népegészségügyi hatóság és a Központi Statisztikai Hivatal együttműködésével

2016 ◽  
Vol 157 (13) ◽  
pp. 504-511
Author(s):  
Mária Szücs ◽  
Dojna Pintérné Grósz ◽  
János Sándor
Keyword(s):  
Public Health ◽  
Cause Of Death ◽  
Health Authority ◽  
Control Method ◽  
International Classification Of Diseases ◽  
Public Health Authority ◽  
Central Statistical ◽  
Central Statistical Office ◽  
Death Data

Introduction: The diagnosis of cause of death is based on the sequence of diagnoses declared by the physician who completes the death certificate that is processed by Central Statistical Office in Hungary. The validity control of the data requires the active involvement of the public health authority. Aim: The authors analyzed the death certificates from Tolna county in order to elaborate and evaluate methods for cause of death data validity control. Method: Diagnoses of cause of death declared by the physician, corrected by the social statistical review in the Central Statistical Office, and revised by public health authority were compared to evaluate the quality of cause of death data. Results: It was found that 5–10% of the cause of death diagnoses declared by physicians required some modification, resulting more than 1% change in county specific mortality statistics of the main International Classification of Diseases groups. Physicians who reported inaccurate cause of death data were identified. 10 indicators were defined to monitor the process elaborated in the project. Conclusions: Co-operation between the Central Statistical Office and public health authorities to improve the quality of cause of death data should be continued because evaluation of public health interventions needs more and more reliable and detailed cause of death statistics. Orv. Hetil., 2016, 157(13), 504–511.

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.

Elastic/Plastic Contact Mechanics-Based Analysis of Hard Disk Drive Media Damage From Slider Corner Impacts

2007 ◽  
Author(s):  
Raja R. Katta ◽  
Andreas A. Polycarpou ◽  
Jorge V. Hanchi
Keyword(s):  
Thin Film ◽  
Contact Mechanics ◽  
Impact Damage ◽  
Disk Drive ◽  
High Impact ◽  
Impact Model ◽  
Elastic Plastic ◽  
The Impact ◽  
Contact Parameters ◽  
Very High

A contact mechanics-based elastic-plastic impact model which considers slider corner – head disk interaction has been proposed. This model estimates the impact contact parameters accounting for the plastic deformation effects of the realistic thin-film disk media. These properties were utilized for the elastic-plastic impact model to estimate the contact parameters. Very high impact velocities and/or small slider corner radii resulted is extremely high contact depths where the disk substrate mostly dominated the impact and the effect of layers could not be seen. At lower impact velocities and higher corner radii, the impact damage was relatively smaller. The effect of the thin-film layers, which are stiffer than the substrate, was clearly observed.

scholarly journals The Role of COVID-19 in the Death of SARS-CoV-2–Positive Patients: A Study Based on Death Certificates

2020 ◽  
Vol 9 (11) ◽  
pp. 3459 ◽  
Author(s):  
Francesco Grippo ◽  
Simone Navarra ◽  
Chiara Orsi ◽  
Valerio Manno ◽  
Enrico Grande ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
Hypertensive Heart Disease ◽  
International Classification Of Diseases ◽  
Death Certificates ◽  
Respiratory Complications ◽  
Classification Of Diseases ◽  
Underlying Cause Of Death ◽  
And Gender ◽  
Low Prevalence

Background: Death certificates are considered the most reliable source of information to compare cause-specific mortality across countries. The aim of the present study was to examine death certificates of persons who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to (a) quantify the number of deaths directly caused by coronavirus 2019 (COVID-19); (b) estimate the most common complications leading to death; and (c) identify the most common comorbidities. Methods: Death certificates of persons who tested positive for SARS-CoV-2 provided to the National Surveillance system were coded according to the 10th edition of the International Classification of Diseases. Deaths due to COVID-19 were defined as those in which COVID-19 was the underlying cause of death. Complications were defined as those conditions reported as originating from COVID-19, and comorbidities were conditions independent of COVID-19. Results: A total of 5311 death certificates of persons dying in March through May 2020 were analysed (16.7% of total deaths). COVID-19 was the underlying cause of death in 88% of cases. Pneumonia and respiratory failure were the most common complications, being identified in 78% and 54% of certificates, respectively. Other complications, including shock, respiratory distress and pulmonary oedema, and heart complications demonstrated a low prevalence, but they were more commonly observed in the 30–59 years age group. Comorbidities were reported in 72% of certificates, with little variation by age and gender. The most common comorbidities were hypertensive heart disease, diabetes, ischaemic heart disease, and neoplasms. Neoplasms and obesity were the main comorbidities among younger people. Discussion: In most persons dying after testing positive for SARS-CoV-2, COVID-19 was the cause directly leading to death. In a large proportion of death certificates, no comorbidities were reported, suggesting that this condition can be fatal in healthy persons. Respiratory complications were common, but non-respiratory complications were also observed.

Deaths with Dementia in Indigenous and Non-Indigenous Australians: A Nationwide Study

2021 ◽  
pp. 1-11
Author(s):  
Michael Waller ◽  
Rachel F. Buckley ◽  
Colin L. Masters ◽  
Francis R. Nona ◽  
Sandra Eades ◽  
...  
Keyword(s):  
Death Certificate ◽  
Relative Rate ◽  
Population Level ◽  
International Classification Of Diseases ◽  
Mortality Data ◽  
Indigenous Australians ◽  
Indigenous Status ◽  
Indigenous Group ◽  
Classification Of Diseases ◽  
Underlying Cause Of Death

Background: The prevalence of dementia is generally reported to be higher among Indigenous peoples. Objective: The rates and coding of dementia mortality were compared between Indigenous and non-Indigenous Australians. Methods: De-identified individual records on causes of death for all people aged 40 years or more who died in Australia between 2006 and 2014 (n = 1,233,084) were used. There were 185,237 records with International Classification of Diseases, Tenth Revision, codes for dementia (Alzheimer’s Disease, vascular dementia, or unspecified dementia) as the underlying cause of death or mentioned elsewhere on the death certificate. Death rates were compared using Poisson regression. Logistic regression was used to assess whether dementia was more likely to be classified as ‘unspecified’ type in Indigenous Australians. Results: The rates of death with dementia were 57% higher in Indigenous Australians, compared to non-Indigenous, relative rate (RR) 1.57, 95% confidence interval (CI) (1.48, 1.66), p <  0.0001. This excess of deaths was highest at ages below 75 (RRs >  2, test for interaction p <  0.0001), and among men (test for interaction p <  0.0001). When the underreporting of Indigenous status on the death certificate was taken into account the relative rate increased to 2.17, 95% CI (2.07, 2.29). Indigenous Australians were also more likely to have their dementia coded as ‘unspecified’ on their death certificate (Odds Ratio 1.92, 95% CI (1.66, 2.21), p <  0.0001), compared to the non-Indigenous group. Conclusion: This epidemiological analysis based on population level mortality data demonstrates the higher dementia-related mortality rate for Indigenous Australians especially at younger ages.

Decline in overall pulmonary embolism-related mortality and increasing prevalence of cancer-associated events in the Veneto region (Italy), 2008-2019

2021 ◽  
Author(s):  
Luca Valerio ◽  
Ugo Fedeli ◽  
Elena Schievano ◽  
Francesco Avossa ◽  
Stefano Barco
Keyword(s):  
Cause Of Death ◽  
Death Certificate ◽  
Northern Italy ◽  
Veneto Region ◽  
Diagnostic Practices ◽  
Epidemiological Changes ◽  
Underlying Cause Of Death ◽  
Standardized Mortality Rate ◽  
Prevalence Of Cancer ◽  
Related Mortality

Background. Despite evidence of ongoing epidemiological changes in deaths from venous thromboembolism in high-income countries, little recent information is available on the time trends in mortality related to PE as underlying or concomitant cause of death in Europe. Methods. We accessed the regional database of death certificates of Veneto Region (Northern Italy, population 4,900,000) from 2008 to 2019. We analysed the trends in crude and age-adjusted annual rates of mortality related to PE (reported either as underlying cause or in any position in the death certificate) using Joinpoint regression; in the contribution of PE to mortality (proportionate mortality); and, using logistic regression, in the association between PE and cancer at death. Results. Between 2008 and 2019, the age-standardized mortality rate related to PE in Veneto decreased from 20.7 to 12.6 annual deaths per 100,000 population for PE in any position of the death certificate, and from 4.6 to 2.2 annual deaths per 100,000 population for PE as underlying cause of death. PE-related proportionate mortality remained up to twice as high in women. The age- and sex-adjusted odds ratio for cancer in deaths with (vs. without) PE constantly increased from 1.01 (95% CI 0.88-1.16) in 2008 to 1.58 (95% CI 1.35-1.83) in 2019. Conclusions. The descending trend in PE-related mortality reported for Europe up to 2015 for both sexes continued thereafter in Northern Italy. However, sex differences in proportionate mortality persist, and the increasing association between PE and cancer at death may reflect changes in risk factor distribution or diagnostic practices.

Abstract P096: Trends in Heart Disease Mortality Among Mississippi Adults Over a Three Decade Period, 1980 Through 2013

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Vincent L. Mendy ◽  
Rodolfo Vargas ◽  
Lamees El-sadek ◽  
Abigail Gamble
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Annual Percent Change ◽  
Percent Change ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Underlying Cause Of Death

Background: Heart disease (HD) mortality has declined in Mississippi over recent decades however it remains as the leading cause of death among Mississippians. Trends in Mississippi HD mortality have not been thoroughly explored. This study examined trends in HD mortality from 1980 through 2013 among Mississippi adults (≥ 25 years) and further assessed trends by race and sex. Methods and Results: Data from Mississippi Vital Statistics (1980 through 2013) were used to calculate age-specific HD mortality rates for Mississippi adults. Cases were identified using underlying cause of death codes from the International Classification of Diseases, Tenth Revision (ICD-10), including I00-I09, I11, I13, and I20-I51. Joinpoint software was used to calculate the average annual percent change in HD mortality rates for the overall population and by race, sex, and race and sex. Overall, the age-adjusted HD mortality rates among Mississippi adults decreased by 36.5% between 1980 and 2013 with an average annual percent change of -1.60% (95% CI -2.0 to -1.3). During this period, HD mortality rates decreased annually on average by -1.30% (95% CI -1.98 to -0.69) for black adults; by -1.60% (95% CI -1.74 to -1.46) for white adults; by -1.30% (95% CI -1.5 to -1.1) for all females, and by -1.90% (95% -2.2 to -1.5) for all males. Conclusions: Between 1980 and 2013 a continual decrease in HD mortality among Mississippi adults was observed. Disparities in the magnitude of the decrease in HD mortality existed by race and sex.

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