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Snowdon J. Recognising inaccuracies in Australian suicide and 'hidden suicide' data. Australas Psychiatry 2024; 32:323-329. [PMID: 38653498 DOI: 10.1177/10398562241245548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To examine the effects of revision of Australian mortality statistics every year since 2007 on numbers and rates of suicide and 'hidden suicide'. METHOD Nine months after the end of each year, the Australian Bureau of Statistics releases preliminary statistics concerning deaths registered in that year, together with revised and finalised data regarding previous years. Numbers and rates of suicide and of deaths coded to selected categories of accidental, undetermined and unknown cause deaths were tabled. RESULTS Upward revision of suicide and accidental drug poisoning death numbers, three years after first release, show that true rates are substantially higher than initially released data suggested. Concomitant downward revision of rates of undetermined and unknown cause deaths supports evidence that at first release some suicides are coded to these categories. CONCLUSIONS Australia's finalised suicide data are likely to be more accurate than equivalent data from nations that do not revise mortality data. More comprehensive investigation (including verbal or psychological autopsy) in doubtful cases in Australia and elsewhere would probably lead to reported suicide rates being higher.
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Affiliation(s)
- John Snowdon
- Department of Psychogeriatrics, Concord Repatriation General Hospital, Concord, NSW, Australia; and
- Speciality of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Tunesi S, Tambuzzi S, Decarli A, Cattaneo C, Russo AG. Trends in mortality from non-natural causes in children and adolescents (0-19 years) in Europe from 2000 to 2018. BMC Public Health 2023; 23:2223. [PMID: 37950237 PMCID: PMC10638782 DOI: 10.1186/s12889-023-17040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Non-natural mortality in children and adolescents is a global public health problem that varies widely from country to country. Data on child and adolescent maltreatment are not readily available, and mortality due to violent causes is also underestimated. METHODS Injury-related mortality rates (overall and by specific causes) from 2000 to 2018 in selected European countries were analysed to observe mortality patterns in children and adolescents using data from the Eurostat database. Age-standardized mortality rates per 100,000 person-years were calculated for each country. Joinpoint regression analysis with a significance level of 0.05 and 95% confidence intervals was performed for mortality trends. RESULTS Children and adolescent mortality from non-natural causes decreased significantly in Europe from 10.48 around 2005 to 5.91 around 2015. The Eastern countries (Romania, Bulgaria, Poland, Slovakia, Czech Republic) had higher rates; while Spain, Denmark, Italy, and the United Kingdom had the lowest. Rates for European Country declined by 5.10% per year over the entire period. Larger downward trends were observed in Ireland, Spain and Portugal; smaller downward trends were observed for Eastern countries (Bulgaria, Czech Republic, Poland, Slovakia) and Finland. Among specific causes of death, the largest decreases were observed for accidental causes (-5.9%) and traffic accidents (-6.8%). CONCLUSIONS Mortality among children and adolescents due to non-natural causes has decreased significantly over the past two decades. Accidental events and transport accidents recorded the greatest decline in mortality rates, although there are still some European countries where the number of deaths among children and adolescents from non-natural causes is high. Social, cultural, and health-related reasons may explain the observed differences between countries.
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Affiliation(s)
- Sara Tunesi
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy
| | - Stefano Tambuzzi
- Bureau of Legal Medicine and Insurance, Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Adriano Decarli
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy
| | - Cristina Cattaneo
- Bureau of Legal Medicine and Insurance, Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Antonio Giampiero Russo
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy.
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Martins Soares Filho A, Lima RBD, Merchan-Hamann E, Souza MDFMD, Mikkelsen L, Mahesh PKB, Adair T. Improving the quality of external cause of death data in Brazil: evaluation and validation of a new form to investigate garbage codes. CAD SAUDE PUBLICA 2023; 39:e00097222. [PMID: 37018771 DOI: 10.1590/0102-311xen097222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/22/2022] [Indexed: 04/05/2023] Open
Abstract
Garbage codes, such as external causes with no specific information, indicate poor quality cause of death data. Investigation of garbage codes via an effective instrument is necessary to convert them into useful data for public health. This study analyzed the performance and suitability of the new investigation of deaths from external causes (IDEC) form to improve the quality of external cause of death data in Brazil. The performance of the IDEC form on 133 external garbage codes deaths was compared with a stratified matched sample of 992 (16%) investigated deaths that used the standard garbage codes form. Consistency between these two groups was checked. The percentage of garbage codes from external causes reclassified into valid causes with a 95% confidence interval (95%CI) was analyzed. Reclassification for specific causes has been described. Qualitative data on the feasibility of the form were recorded by field investigators. Investigation using the new form reduced all external garbage codes by -92.5% (95%CI: -97.0; -88.0), whereas the existing form decreased garbage codes by -60.5% (95%CI: -63.5; -57.4). The IDEC form presented higher effectivity for external-cause garbage codes of determined intent. Deaths that remained garbage codes mainly lacked information about the circumstances of poisoning and/or vehicle accidents. Despite the fact that field investigators considered the IDEC form feasible, they suggested modifications for further improvement. The new form was more effective than the current standard form in improving the quality of defined external causes.
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Soares Filho AM, Duarte E, Adair T, Bermúdez XPD, Merchan-Hamann E. Mortality surveillance in Brazil: factors associated with certification of unspecified external cause of death. CIENCIA & SAUDE COLETIVA 2022; 27:1289-1300. [PMID: 35475812 DOI: 10.1590/1413-81232022274.10422021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/24/2021] [Indexed: 11/22/2022] Open
Abstract
This article aims to analyze the association between characteristics of death - type of certifier and place of death - and the odds of an external cause death being certified as unspecified in Brazil. Cross-sectional study of deaths due to external causes from the Mortality Information System, 2017. Unspecified external cause (UEC) is the outcome variable in the models. Type of certifier physician, place of death and the interaction of these variables were the explanatory variables. Confounders were controlled by multiple logistic regression. UEC were the initial underlying cause for 22% of the 159,720 deaths from external causes in Brazil and 31% of hospital deaths issued by coroners. After adjustment for confounders, the odds of UEC in a hospital death certified by a coroner was 98% greater (OR=1.98; 95%CI: 1.53; 2.56) than in a home/street death issued by another certifier. This was greater than the odds for certifications by coroners (OR=1.23; 95%CI: 1.14; 1.33) and hospital deaths (OR=1.44; 95%CI: 1.32; 1.58). External causes certified by coroners and/or occurring in hospitals have a higher presence of UEC than other deaths; and indicate the need for coordinated initiatives by the health and public security sectors.
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Affiliation(s)
- Adauto Martins Soares Filho
- Faculdade de Ciências da Saúde, Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
| | - Elisabeth Duarte
- Faculdade de Ciências da Saúde, Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
| | - Tim Adair
- Melbourne School of Population and Global Health, University of Melbourne. Carlton Victoria Australia
| | - Ximena Pamela Díaz Bermúdez
- Faculdade de Ciências da Saúde, Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
| | - Edgar Merchan-Hamann
- Faculdade de Ciências da Saúde, Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
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Soares Filho AM, Bermudez XP, Merchan-Hamann E. Frequency and factors associated with recording deaths due to unspecified external causes in Brazil: a cross-sectional study, 2017. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e2020452. [PMID: 33978126 DOI: 10.1590/s1679-49742021000200020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/22/2020] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE To analyze the frequency and factors associated with recording deaths due to unspecified external causes in Brazil. METHODS This was a cross-sectional study of Mortality Information System data for the year 2017. Univariate logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (95%CI) of nonspecific recording according to the explanatory variables - (hospital deaths and deaths certified by coroners). RESULTS Brazil registered 159,720 deaths from external causes; 38.9% occurred in hospital, 83.4% were certified by coroners and 21.7% were from unspecified causes. Factors associated with the recording of unspecified external causes were hospital death (OR=2.00 - 95%CI 1.96;2.05) and the coroner's certification (OR=1.08 - 95%CI 1.04;1.11). CONCLUSION The frequency of recording unspecified external causes is greater for hospital deaths than for coroner's certification.
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Lin CY, Wang LY, Lu TH. Changes in drowning mortality rates and quality of reporting from 2004-2005 to 2014-2015: a comparative study of 61 countries. BMC Public Health 2019; 19:1391. [PMID: 31660919 PMCID: PMC6819554 DOI: 10.1186/s12889-019-7749-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/03/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND This study assessed international variations in changes in drowning mortality rates and the quality of reporting specific information in death certificates over the past decade. METHODS Drowning mortality data of 61 countries were extracted from the World Health Organization Mortality Database. We calculated the percentage change (PC) in age-standardized drowning mortality rates and percentage of drowning deaths reported with unspecified codes between 2004 and 2005 and 2014-2015. RESULTS Of the 61 countries studied, 50 exhibited a reduction in drowning mortality rates from 2004 to 2005 to 2014-2015. Additionally, five countries-Lithuania, Moldova, Kyrgyzstan, Romania, and El Salvador-with a high mortality rate in 2004-2005 (> 40 deaths per 100,000) showed improvement (PC < - 32%). By contrast, four countries-South Africa, Guyana, Morocco, and Guatemala-exhibited a more than twofold increase in mortality rates. Regarding the quality of reporting, 34 countries exhibited a decrease in the percentage of unspecified codes. Additionally, three countries-Paraguay, Serbia, and Croatia-with moderate and high percentages of unspecified codes (> 40%) exhibited a marked reduction (PC < - 60%), whereas three countries-Malaysia, Belgium, and Nicaragua-exhibited a notable increase. CONCLUSIONS Large international variations in the extent of changes in drowning mortality rates and the quality of reporting specific information on the death certificate were observed during the study period.
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Affiliation(s)
- Ching-Yi Lin
- Institute of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Liang-Yi Wang
- NCKU Research Center for Health Data and Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, Dah Hsueh Road, Tainan, 701 Taiwan
| | - Tsung-Hsueh Lu
- NCKU Research Center for Health Data and Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, Dah Hsueh Road, Tainan, 701 Taiwan
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Zelinkova V, Brazinova A, Taylor MS, Rusnak M, Plancikova D, Melichova J, Majdan M. Location of traumatic brain injury-related deaths: epidemiological analysis of 11 European countries. Brain Inj 2019; 33:830-835. [DOI: 10.1080/02699052.2019.1605622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Veronika Zelinkova
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic
| | - Alexandra Brazinova
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic
| | - Mark S Taylor
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic
| | - Martin Rusnak
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic
| | - Dominika Plancikova
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic
| | - Juliana Melichova
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic
| | - Marek Majdan
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic
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Mack KA, Hedegaard H, Ballesteros MF, Warner M, Eames J, Sauber-Schatz E. The need to improve information on road user type in National Vital Statistics System mortality data. TRAFFIC INJURY PREVENTION 2019; 20:276-281. [PMID: 30985191 PMCID: PMC6533142 DOI: 10.1080/15389588.2019.1576036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/17/2019] [Accepted: 01/25/2019] [Indexed: 06/09/2023]
Abstract
Objectives: Both the National Vital Statistics System (NVSS) and the Fatality Analysis Reporting System (FARS) can be used to examine motor vehicle crash (MVC) deaths. These 2 data systems operate independently, using different methods to collect and code information about the type of vehicle (e.g., car, truck, bus) and road user (e.g., occupant, motorcyclist, pedestrian) involved in an MVC. A substantial proportion of MVC deaths in NVSS are coded as "unspecified" road user, which reduces the utility of the NVSS data for describing burden and identifying prevention measures. This study aimed to describe characteristics of unspecified road user deaths in NVSS to further our understanding of how these groups may be similar to occupant road user deaths. Methods: Using data from 1999 to 2015, we compared NVSS and FARS MVC death counts by road user type, overall and by age group, gender, and year. In addition, we examined factors associated with the categorization of an MVC death as unspecified road user such as state of residence of decedent, type of medical death investigation system, and place of death. Results: The number of MVC occupant deaths in NVSS was smaller than that in FARS in each year and the number of unspecified road user deaths in NVSS was greater than that in FARS. The sum of the number of occupant and unspecified road user deaths in NVSS, however, was approximately equal to the number of FARS occupant deaths. Age group and gender distributions were roughly equivalent for NVSS and FARS occupants and NVSS unspecified road users. Within NVSS, the number of MVC deaths listed as unspecified road user varied across states and over time. Other categories of road users (motorcyclists, pedal cyclists, and pedestrians) were consistent when comparing NVSS and FARS. Conclusions: Our findings suggest that the unspecified road user MVC deaths in NVSS look similar to those of MVC occupants according to selected characteristics. Additional study is needed to identify documentation and reporting challenges in individual states and over time and to identify opportunities for improvement in the coding of road user type in NVSS.
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Affiliation(s)
- Karin A Mack
- a National Center for Injury Prevention and Control, Centers for Disease Control & Prevention , Atlanta , Georgia
| | - Holly Hedegaard
- b National Center for Health Statistics, Centers for Disease Control & Prevention , Hyattsville , Maryland
| | - Michael F Ballesteros
- a National Center for Injury Prevention and Control, Centers for Disease Control & Prevention , Atlanta , Georgia
| | - Margaret Warner
- b National Center for Health Statistics, Centers for Disease Control & Prevention , Hyattsville , Maryland
| | - James Eames
- a National Center for Injury Prevention and Control, Centers for Disease Control & Prevention , Atlanta , Georgia
| | - Erin Sauber-Schatz
- a National Center for Injury Prevention and Control, Centers for Disease Control & Prevention , Atlanta , Georgia
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Ning P, Schwebel DC, Chu H, Zhu M, Hu G. Changes in reporting for unintentional injury deaths, United States of America. Bull World Health Organ 2019; 97:190-199. [PMID: 30992632 PMCID: PMC6453323 DOI: 10.2471/blt.18.215327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 11/11/2018] [Accepted: 11/14/2018] [Indexed: 11/27/2022] Open
Abstract
Objective To quantify how changes in reporting of specific causes of death and of selecting underlying cause from among multiple causes of death contribute to trends in mortality from unintentional injury in Americans aged 65 years or older. Methods We extracted age-standardized unintentional injury mortality data in the United States Centers for Disease Control and Prevention online databases from 1999 to 2016. We used an attribution method to calculate two indicators: the proportion of mortality with specific codes out of all mortality; and the proportion of mortality with underlying cause of death selected from multiple causes of death. We conducted a linear regression to examine the changes over time in these proportions and in reported and age-adjusted mortality. Findings From 1999 through 2016, the proportion of cause-specific unintentional injury mortality in this age group increased from 74% in 1999 (136.9 out of 185.0 per 100 000 population) to 85% in 2016 (143.0 out of 169.1 per 100 000 population) based on multiple causes of death codes. The proportions of mortality with underlying cause of death selected out of multiple causes of death rose in all specific causes of unintentional injury except motor vehicle crash. Age-standardized mortality attributed to reporting changes increased steadily between 1999 and 2016. The increases for overall unintentional injury, fall, motor vehicle crash, suffocation, poisoning and fire or hot object were 24.2, 13.5, 2.1, 2.3, 1.6 and 0.4 deaths per 100 000 persons, respectively. Conclusion Changes in data reporting affect trends in overall and specific unintentional injury mortality over time for older Americans.
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Affiliation(s)
- Peishan Ning
- Xiangya School of Public Health, Central South University, Changsha, China
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, United States of America (USA)
| | - Haitao Chu
- School of Public Health, University of Minnesota, Minneapolis, USA
| | - Motao Zhu
- The Research Institute at Nationwide Children's Hospital; Ohio State University, Columbus, USA
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, China
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Ellingsen CL, Ebbing M, Alfsen GC, Vollset SE. Injury death certificates without specification of the circumstances leading to the fatal injury - the Norwegian Cause of Death Registry 2005-2014. Popul Health Metr 2018; 16:20. [PMID: 30583729 PMCID: PMC6304779 DOI: 10.1186/s12963-018-0176-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 12/09/2018] [Indexed: 11/15/2022] Open
Abstract
Background For injury deaths, the underlying cause of death is defined as the circumstances leading to the injury. When this information is missing, the ICD-10 code X59 (Exposure to unspecified factor) is used. Lack of knowledge of factors causing injuries reduces the value of the cause of death statistics. The aim of this study was to identify predictors of X59-coded deaths in Norway, and to assess methods to identify the true underlying cause of injury deaths. Methods We used data from the Norwegian Cause of Death Registry from 2005 to 2014. We used logistic regression to identify determinants of X59-coded deaths. For redistribution of the X59 deaths, we used a multinomial logistic regression model based on the cases where injury circumstances were known. The data were divided into training and test sets. The model was developed on the training set and assessed on the test set before it was applied to the X59 deaths. The models used death certificate information on the nature of injury and demographic characteristics as predictor variables. Furthermore, we mailed a query to the certifying physicians of X59 deaths reported in the year 2015, where we asked for additional information on the circumstances leading to the fatal injury. Results There were 24,963 injury deaths reported to the Cause of Death Registry of Norway 2005–2014. Of these, 6440 (25.8%) lacked information on the circumstances leading to the death. The strongest predictor for a X59 death was the nature of injury (hip fracture), followed by lack of information on the scene of injury. Applying our redistribution algorithm, we estimated that 97% of the X59-coded deaths were accidental falls. The strongest covariate was the nature of injury, followed by place of death and age at death. In 2015, there were 591 X59-coded deaths. Queries were sent to the certifying doctors in 559 cases. Among the informative replies to the query, 88% of the deaths were reclassified to accidental falls. Conclusions A large proportion of injury deaths in Norway lack information on the circumstances leading to the fatal injury. Typically, these deaths represent accidental falls causing hip fracture in elderly individuals.
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Affiliation(s)
- Christian Lycke Ellingsen
- Norwegian Institute of Public Health, PO Box 973, Sentrum N-5808, Bergen, Norway. .,Stavanger University Hospital, PO Box 8100, N-4068, Stavanger, Norway.
| | - Marta Ebbing
- Norwegian Institute of Public Health, PO Box 973, Sentrum N-5808, Bergen, Norway.,Haukeland University Hospital, PO Box 1400, N-5021, Bergen, Norway
| | - G Cecilie Alfsen
- Department of Pathology, Akershus University Hospital, PO Box 1000, N-1478, Lørenskog, Norway.,Faculty of Medicine, University of Oslo, PO Box 1078, Blindern N-0316, Oslo, Norway
| | - Stein Emil Vollset
- Norwegian Institute of Public Health, PO Box 973, Sentrum N-5808, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, N-5018, Bergen, Norway.,Institute for Health Metrics and Evaluation, 2301 Fifth Ave., Suite 600, Seattle, WA, 98121, USA
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Kiadaliri AA, Rosengren BE, Englund M. Fall-related mortality in southern Sweden: a multiple cause of death analysis, 1998-2014. Inj Prev 2017; 25:129-135. [PMID: 29056585 DOI: 10.1136/injuryprev-2017-042425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 09/22/2017] [Accepted: 10/10/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate temporal trend in fall mortality among adults (aged ≥20 years) in southern Sweden using multiple cause of death data. METHODS We examined all death certificates (DCs, n=2 01 488) in adults recorded in the Skåne region during 1998-2014. We identified all fall deaths using International Statistical Classification of Diseases (ICD)-10 codes (W00-W19) and calculated the mortality rates by age and sex. Temporal trends were evaluated using joinpoint regression and associated causes were identified by age-adjusted and sex-adjusted observed/expected ratios. RESULTS Falls were mentioned on 1.0% and selected as underlying cause in 0.7% of all DCs, with the highest frequency among those aged ≥70 years. The majority (75.6%) of fall deaths were coded as unspecified fall (ICD-10 code: W19) followed by falling on or from stairs/steps (7.7%, ICD-10 code: W10) and other falls on the same level (6.3%, ICD-10 code: W18). The mean age at fall deaths increased from 77.5 years in 1998-2002 to 82.9 years in 2010-2014 while for other deaths it increased from 78.5 to 79.8 years over the same period. The overall mean age-standardised rate of fall mortality was 8.3 and 4.0 per 1 00 000 person-years in men and women, respectively, and increased by 1.7% per year in men and 0.8% per year in women during 1998-2014. Head injury and diseases of the circulatory system were recorded as contributing cause on 48.7% of fall deaths. CONCLUSIONS There is an increasing trend of deaths due to falls in southern Sweden. Further investigations are required to explain this observation particularly among elderly men.
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Affiliation(s)
- Aliasghar A Kiadaliri
- Faculty of Medicine, Department of Clinical Sciences, Orthopaedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - Björn E Rosengren
- Clinical and Molecular Research Unit, Departments of Orthopedics and Clinical Sciences, Skåne University Hospital Malmö, Lund University, Malmö, Sweden
| | - Martin Englund
- Faculty of Medicine, Department of Clinical Sciences, Orthopaedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden.,Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA
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Mack K, Clapperton A, Macpherson A, Sleet D, Newton D, Murdoch J, Mackay JM, Berecki-Gisolf J, Wilkins N, Marr A, Ballesteros M, McClure R. Trends in the leading causes of injury mortality, Australia, Canada, and the United States, 2000-2014. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2017; 108:e185-e191. [PMID: 28621655 PMCID: PMC5788297 DOI: 10.17269/cjph.108.5695] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 03/20/2017] [Accepted: 01/30/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to highlight the differences in injury rates between populations through a descriptive epidemiological study of population-level trends in injury mortality for the high-income countries of Australia, Canada and the United States. METHODS Mortality data were available for the US from 2000 to 2014, and for Canada and Australia from 2000 to 2012. Injury causes were defined using the International Classification of Diseases, Tenth Revision external cause codes, and were grouped into major causes. Rates were direct-method age-adjusted using the US 2000 projected population as the standard age distribution. RESULTS US motor vehicle injury mortality rates declined from 2000 to 2014 but remained markedly higher than those of Australia or Canada. In all three countries, fall injury mortality rates increased from 2000 to 2014. US homicide mortality rates declined, but remained higher than those of Australia and Canada. While the US had the lowest suicide rate in 2000, it increased by 24% during 2000-2014, and by 2012 was about 14% higher than that in Australia and Canada. The poisoning mortality rate in the US increased dramatically from 2000 to 2014. CONCLUSION Results show marked differences and striking similarities in injury mortality between the countries and within countries over time. The observed trends differed by injury cause category. The substantial differences in injury rates between similarly resourced populations raises important questions about the role of societal-level factors as underlying causes of the differential distribution of injury in our communities.
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Affiliation(s)
- Karin Mack
- US Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GA.
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Mortality from Unspecified Unintentional Injury among Individuals Aged 65 Years and Older by U.S. State, 1999-2013. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080763. [PMID: 27472356 PMCID: PMC4997449 DOI: 10.3390/ijerph13080763] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 07/17/2016] [Accepted: 07/22/2016] [Indexed: 11/24/2022]
Abstract
Introduction: Recent changes in unspecified unintentional injury mortality for the elderly by U.S. state remain unreported. This study aims to examine U.S. state variations in mortality from unspecified unintentional injury among Americans aged 65+, 1999–2013; Methods: Using mortality rates from the U.S. CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™), we examined unspecified unintentional injury mortality for older adults aged 65+ from 1999 to 2013 by state. Specifically, the proportion of unintentional injury deaths with unspecified external cause in the data was considered. Linear regression examined the statistical significance of changes in proportion of unspecified unintentional injury from 1999 to 2013; Results: Of the 36 U.S. states with stable mortality rates, over 8-fold differences were observed for both the mortality rates and the proportions of unspecified unintentional injury for Americans aged 65+ during 1999–2013. Twenty-nine of the 36 states showed reductions in the proportion of unspecified unintentional injury cause, with Oklahoma (−89%), Massachusetts (−86%) and Oregon (−81%) displaying the largest changes. As unspecified unintentional injury mortality decreased, mortality from falls in 28 states and poisoning in 3 states increased significantly. Mortality from suffocation in 15 states, motor vehicle traffic crashes in 12 states, and fire/burn in 8 states also decreased; Conclusions: The proportion of unintentional injuries among older adults with unspecified cause decreased significantly for many states in the United States from 1999 to 2013. The reduced proportion of unspecified injury has implications for research and practice. It should be considered in state-level trend analysis during 1999–2013. It also suggests comparisons between states for specific injury mortality should be conducted with caution, as large differences in unspecified injury mortality across states and over time could create bias for specified injury mortality comparisons.
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Danilova I, Shkolnikov VM, Jdanov DA, Meslé F, Vallin J. Identifying potential differences in cause-of-death coding practices across Russian regions. Popul Health Metr 2016; 14:8. [PMID: 27006644 PMCID: PMC4802884 DOI: 10.1186/s12963-016-0078-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/15/2016] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Reliable and comparable data on causes of death are crucial for public health analysis, but the usefulness of these data can be markedly diminished when the approach to coding is not standardized across territories and/or over time. Because the Russian system of producing information on causes of death is highly decentralized, there may be discrepancies in the coding practices employed across the country. In this study, we evaluate the uniformity of cause-of-death coding practices across Russian regions using an indirect method. METHODS Based on 2002-2012 mortality data, we estimate the prevalence of the major causes of death (70 causes) in the mortality structures of 52 Russian regions. For each region-cause combination we measured the degree to which the share of a certain cause in the mortality structure of a certain region deviates from the respective inter-regional average share. We use heat map visualization and a regression model to determine whether there is regularity in the causes and the regions that is more likely to deviate from the average level across all regions. In addition to analyzing the comparability of cause-specific mortality structures in a spatial dimension, we examine the regional cause-of-death time series to identify the causes with temporal trends that vary greatly across regions. RESULTS A high level of consistency was found both across regions and over time for transport accidents, most of the neoplasms, congenital malformations, and perinatal conditions. However, a high degree of inconsistency was found for mental and behavioral disorders, diseases of the nervous system, endocrine disorders, ill-defined causes of death, and certain cardiovascular diseases. This finding suggests that the coding practices for these causes of death are not uniform across regions. The level of consistency improves when causes of death can be grouped into broader diagnostic categories. CONCLUSION This systematic analysis allows us to present a broader picture of the quality of cause-of-death coding at the regional level. For some causes of death, there is a high degree of variance across regions in the likelihood that these causes will be chosen as the underlying causes. In addition, for some causes of death the mortality statistics reflect the coding practices, rather than the real epidemiological situation.
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Affiliation(s)
- Inna Danilova
- />Max Planck Institute for Demographic Research, Konrad-Zuse-Strasse 1, 18057 Rostock, Germany
- />National Research University Higher School of Economics, Myasnitskaya St. 20, 101000 Moscow, Russia
| | - Vladimir M. Shkolnikov
- />Max Planck Institute for Demographic Research, Konrad-Zuse-Strasse 1, 18057 Rostock, Germany
- />New Economic School, Novaya St. 100, Skolkovo, 143026 Moscow, Russia
| | - Dmitri A. Jdanov
- />Max Planck Institute for Demographic Research, Konrad-Zuse-Strasse 1, 18057 Rostock, Germany
- />New Economic School, Novaya St. 100, Skolkovo, 143026 Moscow, Russia
| | - France Meslé
- />Institut national d’études démographiques, Blvd. Davout 133, 75020 Paris, France
| | - Jacques Vallin
- />Institut national d’études démographiques, Blvd. Davout 133, 75020 Paris, France
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15
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Nevalainen O, Simola M, Ansakorpi H, Raitanen J, Artama M, Isojärvi J, Auvinen A. Epilepsy, excess deaths and years of life lost from external causes. Eur J Epidemiol 2015; 31:445-53. [DOI: 10.1007/s10654-015-0095-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 10/22/2015] [Indexed: 11/30/2022]
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16
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Certification of Coroners cases by pathologists would improve the completeness of death registration in Jamaica. J Clin Epidemiol 2015; 68:979-87. [DOI: 10.1016/j.jclinepi.2014.11.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 11/04/2014] [Accepted: 11/21/2014] [Indexed: 11/19/2022]
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17
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Hu G, Mamady K. Impact of changes in specificity of data recording on cause-specific injury mortality in the United States, 1999-2010. BMC Public Health 2014; 14:1010. [PMID: 25262245 PMCID: PMC4246427 DOI: 10.1186/1471-2458-14-1010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/22/2014] [Indexed: 11/17/2022] Open
Abstract
Background We aimed to examine changes in the specificity of data recording and assess the impact on cause-specific injury mortality during 1999–2010. Methods A longitudinal study was designed to analyze injury mortality data of 1999-2010. Mortality rates for unspecified injury and for cause-specific injury were obtained using CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™). The proportion of unspecified injury was used to measure the specificity of injury data recording. We used the proportionate method to adjust data specificity and compared changes in cause-specific mortality before and after adjustment. Results Between 1999 and 2010, the age-adjusted mortality from unspecified injuries decreased from 3.4 to 2.5 per 100,000 persons for all ages. The proportion of unspecified unintentional injury decreased from 18.9% to 10.9% for the elderly ages 65+. The proportion of unspecified homicide significantly increased for all age groups except ages 25–44 years. After adjustment, increases in age-adjusted mortality rates from falls, poisoning and drowning were less (77 vs. 61%, 66 vs. 51%, and 9 vs. 0%) and decreases in injuries from motor vehicle crashes, suffocation, fire/burn, and natural/environmental disasters were greater (-30 vs. -37%, -17 vs. -24%, -23 vs. -24%, and -46 vs. -51%), respectively. The adjustment resulted in reversed changes in homicide by firearm (-1 vs. 5%) and cut/pierce (-5 vs. 2%), greater increases in homicide by suffocation (9 vs. 16%) for ages 45–64 years, and smaller decreases in all other age- and cause-specific homicide groups. Conclusions During 1999–2010, the specificity of data recording changed significantly for homicide rates and elderly unintentional injury mortality and the changes altered trends in cause-specific injury mortality.
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Affiliation(s)
- Guoqing Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, China.
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18
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Lu TH, Chang WT, Lin JJ, Li CY. Suicide method runs in families: a birth certificate cohort study of adolescent suicide in Taiwan. Suicide Life Threat Behav 2011; 41:685-90. [PMID: 22145827 DOI: 10.1111/j.1943-278x.2011.00064.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Suicide method used by adolescents was examined to determine if it was the same as that employed by their suicidal parents. Six hundred eighty adolescents completed suicide between 1997 and 2007, of whom 12 had parents who had previously died by suicide. The suicide method used by these adolescents was compared with that employed by their suicidal parent and that of a matched peer control adolescent with no exposure to parental suicide and living in the same area. In 10 of the 12 suicidal parent-adolescent dyads, the same suicide method was employed by parent and adolescent. Of seven adolescents whose age at parental suicide was 15 years or above, six used the same suicide method as their suicidal parent had. On the contrary, of 12 exposure-nonexposure suicidal adolescent dyads, the same method was used in only four. Adolescents exposed to parental suicide are more likely to use the suicide method employed by their suicidal parents than the method used by adolescent peers with no exposure to parental suicide.
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Affiliation(s)
- Tsung-Hsueh Lu
- National Cheng Kung University, College of Medicine, NCKU Research Center for Health Data and Graduate Institute of Public Health, Tainan, Taiwan
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McKenzie K, Fingerhut L, Walker S, Harrison A, Harrison JE. Classifying external causes of injury: history, current approaches, and future directions. Epidemiol Rev 2011; 34:4-16. [PMID: 22045696 DOI: 10.1093/epirev/mxr014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The International Classification of Diseases (ICD) is used to categorize diseases, injuries, and external causes of injury, and it is a key epidemiologic tool enabling storage and retrieval of data from health and vital records to produce core international mortality and morbidity statistics. The ICD is updated periodically to ensure the classification system remains current, and work is now under way to develop the next revision, ICD-11. It has been almost 20 years since the last ICD edition was published and over 60 years since the last substantial structural revision of the external causes chapter. Revision of such a critical tool requires transparency and documentation to ensure that changes made to the classification system are recorded comprehensively for future reference. In this paper, the authors provide a history of the development of external causes classification and outline the external cause structure. They discuss approaches to manage ICD-10 deficiencies and outline the ICD-11 revision approach regarding the development of, rationale for, and implications of proposed changes to the chapter. Through improved capture of external cause concepts in ICD-11, a stronger evidence base will be available to inform injury prevention, treatment, rehabilitation, and policy initiatives to ultimately contribute to a reduction in injury morbidity and mortality.
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Affiliation(s)
- Kirsten McKenzie
- National Centre for Health Information Research and Training, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, Australia 4059.
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Chandran A, Hyder AA, Peek-Asa C. The global burden of unintentional injuries and an agenda for progress. Epidemiol Rev 2010; 32:110-20. [PMID: 20570956 DOI: 10.1093/epirev/mxq009] [Citation(s) in RCA: 279] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
According to the World Health Organization, unintentional injuries were responsible for over 3.9 million deaths and over 138 million disability-adjusted life-years in 2004, with over 90% of those occurring in low- and middle-income countries (LMIC). This paper utilizes the year 2004 World Health Organization Global Burden of Disease Study estimates to illustrate the global and regional burden of unintentional injuries and injury rates, stratified by cause, region, age, and gender. The worldwide rate of unintentional injuries is 61 per 100,000 population per year. Overall, road traffic injuries make up the largest proportion of unintentional injury deaths (33%). When standardized per 100,000 population, the death rate is nearly double in LMIC versus high-income countries (65 vs. 35 per 100,000), and the rate of disability-adjusted life-years is more than triple in LMIC (2,398 vs. 774 per 100,000). This paper calls for more action around 5 core areas that need research investments and capacity development, particularly in LMIC: 1) improving injury data collection, 2) defining the epidemiology of unintentional injuries, 3) estimating the costs of injuries, 4) understanding public perceptions about injury causation, and 5) engaging with policy makers to improve injury prevention and control.
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Affiliation(s)
- Aruna Chandran
- International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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Lu TH, Lunetta P, Walker S. Quality of cause-of-death reporting using ICD-10 drowning codes: a descriptive study of 69 countries. BMC Med Res Methodol 2010; 10:30. [PMID: 20374660 PMCID: PMC2858216 DOI: 10.1186/1471-2288-10-30] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 04/08/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The systematic collection of high-quality mortality data is a prerequisite in designing relevant drowning prevention programmes. This descriptive study aimed to assess the quality (i.e., level of specificity) of cause-of-death reporting using ICD-10 drowning codes across 69 countries. METHODS World Health Organization (WHO) mortality data were extracted for analysis. The proportion of unintentional drowning deaths coded as unspecified at the 3-character level (ICD-10 code W74) and for which the place of occurrence was unspecified at the 4th character (.9) were calculated for each country as indicators of the quality of cause-of-death reporting. RESULTS In 32 of the 69 countries studied, the percentage of cases of unintentional drowning coded as unspecified at the 3-character level exceeded 50%, and in 19 countries, this percentage exceeded 80%; in contrast, the percentage was lower than 10% in only 10 countries. In 21 of the 56 countries that report 4-character codes, the percentage of unintentional drowning deaths for which the place of occurrence was unspecified at the 4th character exceeded 50%, and in 15 countries, exceeded 90%; in only 14 countries was this percentage lower than 10%. CONCLUSION Despite the introduction of more specific subcategories for drowning in the ICD-10, many countries were found to be failing to report sufficiently specific codes in drowning mortality data submitted to the WHO.
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Affiliation(s)
- Tsung-Hsueh Lu
- NCKU Research Center of Health Data and Institute of Public Health, College of Medicine, National Cheng Kung University, No. 1, Dah Hsueh Road, Tainan, Taiwan
| | - Philippe Lunetta
- Hjelt Institute, Department of Forensic Medicine, University of Helsinki, and National Institute for Health and Welfare, Injury Prevention Unit, 00300 Helsinki, Finland
| | - Sue Walker
- National Centre for Health Information Research and Training, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Australia
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Lam MK, Innes K, Saad P, Rust J, Dimitropoulos V, Cumerlato M. An Evaluation of the Quality of Obstetric Morbidity Coding Using an Objective Assessment Tool, the Performance Indicators for Coding Quality (PICQ). HEALTH INF MANAG J 2008; 37:19-29. [DOI: 10.1177/183335830803700203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Performance Indicators for Coding Quality (PICQ) is a data quality assessment tool developed by Australia's National Centre for Classification in Health (NCCH). PICQ consists of a number of indicators covering all ICD-10-AM disease chapters, some procedure chapters from the Australian Classification of Health Intervention (ACHI) and some Australian Coding Standards (ACS). The indicators can be used to assess the coding quality of hospital morbidity data by monitoring compliance of coding conventions and ACS; this enables the identification of particular records that may be incorrectly coded, thus providing a measure of data quality. There are 31 obstetric indicators available for the ICD-10-AM Fourth Edition. Twenty of these 31 indicators were classified as Fatal, nine as Warning and two Relative. These indicators were used to examine coding quality of obstetric records in the 2004–2005 financial year Australian national hospital morbidity dataset. Records with obstetric disease or procedure codes listed anywhere in the code string were extracted and exported from the SPSS source file. Data were then imported into a Microsoft Access database table as per PICQ instructions, and run against all Fatal and Warning and Relative ( N=31) obstetric PICQ 2006 Fourth Edition Indicators v.5 for the ICD-10-AM Fourth Edition. There were 689,905 gynaecological and obstetric records in the 2004–2005 financial year, of which 1.14% were found to have triggered Fatal degree errors, 3.78% Warning degree errors and 8.35% Relative degree errors. The types of errors include completeness, redundancy, specificity and sequencing problems. It was found that PICQ is a useful initial screening tool for the assessment of ICD-10-AM/ACHI coding quality. The overall quality of codes assigned to obstetric records in the 2004–2005 Australian national morbidity dataset is of fair quality.
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Affiliation(s)
- Mary K Lam
- Mary K Lam BA(Hons), MHIM, PhD, Senior Research Fellow, National Centre for Classification in Health, The University of Sydney, PO Box 170, Lidcombe NSW 1825, AUSTRALIA, Phone: +61 2 9351 9172, Fax: +61 2 9351 9603
| | - Kerry Innes
- Kerry Innes AssocDip(MRA), Associate Director, National Centre for Classification in Health, The University of Sydney, PO Box 170, Lidcombe NSW 1825, AUSTRALIA
| | - Patricia Saad
- Patricia Saad BAppSc(HIM), Project Officer, National Centre for Classification in Health, The University of Sydney, PO Box 170, Lidcombe NSW 1825, AUSTRALIA
| | - Julie Rust
- Julie Rust BAppSc(HIM), Project Officer, National Centre for Classification in Health, The University of Sydney, PO Box 170, Lidcombe NSW 1825, AUSTRALIA
| | - Vera Dimitropoulos
- Vera Dimitropoulos BAppSc(HIM), Classification Support Manager, National Centre for Classification in Health, The University of Sydney, PO Box 170, Lidcombe NSW 1825, AUSTRALIA
| | - Megan Cumerlato
- Megan Cumerlato BAppSc(HIM), Education Coordinator, National Centre for Classification in Health, The University of Sydney, PO Box 170, Lidcombe NSW 1825, AUSTRALIA
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