scholarly journals Evaluation of Medical Certification of Cause of Death of Tertiary Cancer Hospitals of Northern India

2021 ◽  
Author(s):  
Akash Anand ◽  
Divya Khanna ◽  
Payal Singh ◽  
Anuj Singh ◽  
Abhishek Pandey ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Medical Records ◽  
Cardiopulmonary Arrest ◽  
Disease Incidence ◽  
High Rate ◽  
Local Health ◽  
Death Certificates ◽  
Northern India ◽  
Medical Certification ◽  
Local Health Policy

Abstract BackgroundMedical Certification of Cause of Death (MCCD) can provide valuable health status data regarding disease incidence, prevalence and mortality in a community. It can guide local health policy and help in setting priorities. On the contrary, incomplete and inaccurate MCCD data can significantly impair the precision of a national health information database. In the current study, the accuracy of death certificates at two tertiary cancer care hospitals in Northern India, has been evaluated.MethodsThis retrospective study has been conducted at Tata Memorial Centres namely, Mahamana Pandit Madan Mohan Malaviya Cancer Centre and Homi Bhabha Cancer Hospital, Varanasi, India on MCCD over a period of two and a half years. Medical records and death certificates of all the deceased were examined. The demographic characteristics, administrative details, co-morbidities and cause of death from death certificates were collected using an approved standardized form. The accuracy of this information was validated using the medical records. Errors in the death certificates were classified according to Haque’s grading scale.1Results778 deaths occurred during the study period between May 2018 to December 2020, and all certificates were accessed for analysis. Only 30 (4%) certificates were error-free. 591(75.9%) death certificates had an inappropriate immediate cause of death. 231(29.7%) death certificates had incorrectly labelled mode of death, such as cardiopulmonary arrest as the immediate cause of death. 585 (75.2%) death certificates had an incorrect underlying cause of death. Majority of the death certificates were prepared by the post MBBS junior residents and this was significantly associated with higher certification errors.ConclusionA high rate of errors was identified in the death certificates completed at our hospitals. Inaccurate death certificates related to cancers can potentially influence the cancer statistics of the defined region and thereby affect policymaking for cancer prevention and control. There is a pressing need for appropriate intervention/s to resolve this important issue. In an attempt to improve the quality of certification, it is envisaged to conduct training for all consultants and residents in proper death certification.

scholarly journals Social, demographic, health care and co-morbidity predictors of tuberculosis mortality in Amazonas, Brazil: a multiple cause of death approach

2019 ◽  
Author(s):  
Vanderson de Souza Sampaio ◽  
Leila Cristina Ferreira da Silva ◽  
Daniel Barros de Castro ◽  
Patrícia Carvalho da Silva Balieiro ◽  
Ana Alzira Cabrinha ◽  
...  
Keyword(s):  
Health Care ◽  
Cause Of Death ◽  
Conflicts Of Interest ◽  
Multinomial Logistic Regression ◽  
Disease Incidence ◽  
Mortality Rates ◽  
The State ◽  
Death Certificates ◽  
Co Morbidity ◽  
State Capital

AbstractOBJECTIVESTo estimate TB mortality rates, describe multiple causes in death certificates in which TB was reported and identify predictors of TB reporting in death certificates in the State of Amazonas, Brazil, based on a multiple cause of death approach.METHODSDeath records of residents in AM within 2006-2014 were classified based on tuberculosis reporting in the death certificate as tuberculosis not reported (TBNoR), reported as the underlying cause of death (TBUC) and as an associate cause of death (TBAC). Age standardized annual mortality rates for TBUC, TBAC and with TB reported (TBUC plus TBAC) were estimated for the State of Amazonas, using the direct standardization method and WHO 2000-2025 standard population. Mortality odds ratios (OR) of reporting TBUC and TBAC were estimated using multinomial logistic regression.RESULTSAge standardized annual TBUC and TBAC mortality rates ranged, between 5.9-7.8/105 and 2.7-4.0/105, respectively. TBUC was associated with residence in the State capital (OR=0.66), female sex (OR=0.87), education level (OR=0.67 and 0.50 for 8 to 11 and 12 or more school years), non-white race/skin colour (OR=1.38) and occurrence of death in the State capital (OR=1.69). TBAC was related to time (OR=1.21 and 1.22 for years 2009-11 and 2012-14), age (OR=36.1 and 16.5 for ages 15-39 and 40-64 years) and when death occurred in the State capital (OR=5.8).CONCLUSIONTBUC was predominantly associated with indicators of unfavorable socioeconomic conditions and health care access constraints, whereas TBAC was mainly related to ages typical of high HIV disease incidence.Conflicts of interestNone.FundingFundação de Amparo à Pesquisa do Estado do Amazonas - FAPEAM

scholarly journals Effect of Compost Amendments on Disease Severity and Yield of Tomato in Conventional and Organic Production Systems

Plant Disease ◽  
2002 ◽  
Vol 86 (2) ◽  
pp. 156-161 ◽  
Author(s):  
P. A. Abbasi ◽  
J. Al-Dahmani ◽  
F. Sahin ◽  
H. A. J. Hoitink ◽  
S. A. Miller
Keyword(s):  
Disease Severity ◽  
Production Systems ◽  
Disease Incidence ◽  
Organic Production ◽  
Fruit Rot ◽  
High Rate ◽  
Bacterial Spot ◽  
Marketable Yield ◽  
Tomato Production ◽  
Compost Amendments

Field trials were conducted over 2 years to assess the effects of compost amendments on disease development in organic and conventional processing tomato (Lycopersicon esculentum L.) production systems. The incidence of anthracnose fruit rot was reduced in organic tomato plots amended with a high rate of composted cannery wastes compared with the incidence in nonamended control plots in 1998 when disease incidence was high. Marketable yield was increased by 33% in compost-amended organic plots. Plots amended with a high compost rate had more ripe fruit than the nonamended control. The incidence of anthracnose and of total disease on fruit was less on the cultivar OH 8245 than on Peto 696. Total fruit yield of OH 8245 but not Peto 696 in organic plots was increased by amendment with composted cannery wastes. In conventional tomato production, composted yard wastes increased disease severity on foliage both years but reduced bacterial spot incidence on fruit in 1997, when disease pressure was high. The incidence of anthracnose was not affected by composted yard wastes. Marketable and total fruit yields of Peto 696 were not increased in compost-amended conventional plots. The plant activator Actigard reduced foliar disease severity and the incidence of bacterial spot and anthracnose on fruit, while increasing yield of marketable fruit.

scholarly journals Can verbal autopsy improve the diagnostic accuracy of Physicians in Shanghai? Application of SmartVA

2021 ◽  
Author(s):  
Lei Chen ◽  
Tian Xia ◽  
Rasika Rampatige ◽  
Hang Li ◽  
Tim Adair ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Verbal Autopsy ◽  
Medical Records ◽  
Community Health Centers ◽  
Causes Of Death ◽  
Practical Method ◽  
Initial Diagnosis ◽  
Hospital Death ◽  
Routine Practice ◽  
Record Review

Abstract Background Accurate data on causes of death are essential for policy makers and public health experts to plan appropriate health policies and interventions to improve population health. Whereas approximately 30% deaths of Shanghai either occur at home or are not medically attended; the recorded cause of death in these cases may be less reliable than for a hospital death. Verbal Autopsy is a practical method that can help determine causes of death in regions where medical records are insufficient or unavailable. In this research, the smart VA tool was adopted to assign the cause of death of home deaths and to validate the accuracy and efficiency of the tool, the results were compared with routine practice to ascertain the value, if any, of incorporating VA into the diagnostic practices of physician in Shanghai certifying the cause of home deaths. Methods This pilot study selected home deaths certified by 16 community health centers from 3 districts represent urban, suburb, and urban-suburb areas in Shanghai, from December 2017 to June 2018. The medical records for all deaths for which a VA was carried out in these 3 districts during same period were carefully evaluated an independent Medical Record Review (MRR) team. Causes of death from both the SmartVA sample and the UCOD from the MRR were transformed to the SmartVA cause list for comparison. The concordance between the initial diagnosis and MRR UCOD and post-VA diagnosis and MRR UCOD was assessed using Chance Corrected Concordance. Results Overall CSMF accuracy improved from 0.93, based on the initial diagnosis, to 0.96 after the application of SmartVA. The misclassification of the initial diagnosis compared to that from the MRR. 86.3% of the initial diagnoses assigned the correct CODs, after the VA investigation, 90.5% of the post-VA diagnosis assigned the correct CODs. Conclusions Although Shanghai has an established and well-functioning CRVS system, SmartVA for Physicians contributed to an improvement in the accuracy of death certification. In addition, SmartVA may be a useful tool for inferring some special causes of death, such as those CODs classified as undetermined.

scholarly journals Gastrointestinal Manifestations in Mucopolysaccharidosis Type III: Review of Death Certificates and the Literature

2021 ◽  
Vol 10 (19) ◽  
pp. 4445
Author(s):  
Sophie Thomas ◽  
Uma Ramaswami ◽  
Maureen Cleary ◽  
Medeah Yaqub ◽  
Eva M. Raebel
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Clinical Feature ◽  
Mucopolysaccharidosis Type ◽  
Death Certificates ◽  
Type Iii ◽  
Mucopolysaccharidosis Type Iii ◽  
Gi Symptoms ◽  
Tract Infections ◽  
Mps Iii

Background: Mucopolysaccharidosis type III (MPS III, Sanfilippo disease) is a life-limiting recessive lysosomal storage disorder caused by a deficiency in the enzymes involved in degrading glycosaminoglycan heparan sulfate. MPS III is characterized by progressive deterioration of the central nervous system. Respiratory tract infections have been reported as frequent and as the most common cause of death, but gastrointestinal (GI) manifestations have not been acknowledged as a cause of concern. The aim of this study was to determine the incidence of GI problems as a primary cause of death and to review GI symptoms reported in published studies. Methods: Causes of death from 221 UK death certificates (1957–2020) were reviewed and the literature was searched to ascertain reported GI symptoms. Results: GI manifestations were listed in 5.9% (n = 13) of death certificates. Median (IQR) age at death was 16.7 (5.3) years. Causes of death included GI failure, GI bleed, haemorrhagic pancreatitis, perforation due to gastrostomies, paralytic ileus and emaciation. Twenty-one GI conditions were reported in 30 studies, mostly related to functional GI disorders, including diarrhoea, dysphagia, constipation, faecal incontinence, abdominal pain/distension and cachexia. Conclusions: GI manifestations may be an under-recognized but important clinical feature of MPS III. Early recognition of GI symptoms and timely interventions is an important part of the management of MPS III patients.

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