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Apostolović MA, Stojanović M, Bogdanović D, Apostolović B, Topalović M, Milošević Z, Marković R, Ignjatović A. Assessment of the Quality of Cause-of-Death Data in Serbia for 2005-2019 Vital Statistics Performance Index Estimation. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:1528-1536. [PMID: 39086425 PMCID: PMC11287600 DOI: 10.18502/ijph.v53i7.16047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/11/2023] [Indexed: 08/02/2024]
Abstract
Background We aimed to evaluate the quality of the cause of death (COD) concerning mortality patterns and completeness of death registration to identify areas for improvement in Serbia. Methods COD data collected from the mortality register in Serbia from 2005 to 2019 (1540615 deaths) were analyzed with the software Analysis of National Causes of Death for Action. The Vital Statistics Performance Index for Quality (VSPI(Q)) is estimated for the overall COD data quality. Results The completeness of death certification was higher than 98%. Usable underlying COD was registered in 57%, 24.1% with an unusable and 18.6% with insufficiently specified COD. The VSPI(Q) was 67.2%, denoting medium quality. The typical error was using intermediate COD (24.7% of all deaths), while 13.2% and 8.5% of all garbage codes (GC) belonged to the Very High and High Severity classes. The leading underlying COD is unspecified cardiomyopathy. The analysis revealed that 39.1% of GC has been redistributed to non-communicable diseases, 2.5% to external causes and 1.1% to communicable diseases. Conclusion In the 15 years' worth of data analyzed, the true underlying COD, in many cases, was ill-defined, indicating that COD data at the national level could be distorted. The additional and continuous professional education of medical students as well as physicians is needed. It should focus on the most common GC among the leading COD and acquiring skills in certifying external causes of death.
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Affiliation(s)
- Marija Anđelković Apostolović
- Department of Medical Statistics and Informatics, Medical Faculty University of Niš, Niš, Serbia
- Center for Informatics and Biostatistics in Health Care, Institute of Public Health Niš, Niš, Serbia
| | - Miodrag Stojanović
- Department of Medical Statistics and Informatics, Medical Faculty University of Niš, Niš, Serbia
- Center for Informatics and Biostatistics in Health Care, Institute of Public Health Niš, Niš, Serbia
| | - Dragan Bogdanović
- Center for Informatics and Biostatistics in Health Care, Institute of Public Health Niš, Niš, Serbia
- State University of Novi Pazar, Novi Pazar, Serbia
| | | | - Marija Topalović
- Department of Pulmonology, University Clinical Center Niš, Niš, Serbia
| | - Zoran Milošević
- Department of Medical Statistics and Informatics, Medical Faculty University of Niš, Niš, Serbia
- Center for Informatics and Biostatistics in Health Care, Institute of Public Health Niš, Niš, Serbia
| | - Roberta Marković
- Department of Medical Statistics and Informatics, Medical Faculty University of Niš, Niš, Serbia
- Center for Health Promotion, Institute of Public Health Niš, Niš, Serbia
| | - Aleksandra Ignjatović
- Department of Medical Statistics and Informatics, Medical Faculty University of Niš, Niš, Serbia
- Center for Informatics and Biostatistics in Health Care, Institute of Public Health Niš, Niš, Serbia
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Millares Martin P, Allsop MJ, Carder P. Will medical cause of death certifications data quality improve in the UK with the new medical examiner system? J Forensic Leg Med 2023; 99:102589. [PMID: 37738944 DOI: 10.1016/j.jflm.2023.102589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/14/2023] [Accepted: 09/06/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVES There are deficits in the completeness, accuracy and timeliness of death certification internationally. In April 2023, England implemented a statutory Medical Examiners system primarily aiming to improve the quality of certification of death data. We sought to assess the current quality of death certification among general practitioners and medical examiners. METHODS An online survey was conducted with general practitioners and medical examiners in the Yorkshire region to determine how Medical Certifications of Cause of Death (MCCD) are completed and commonly experienced sources of errors (e.g., a lack of a reported time frame, absent or inadequate reporting of comorbidities, incorrect underlying cause-of-death, and an inaccurate sequence of events). RESULTS The survey was completed by general practitioners (n = 95) and medical examiners (n = 9). Participant responses, including to a hypothetical case, confirmed the quality of the certification was less variable among MEs compared to GPs, but still below international standards. CONCLUSIONS Efforts to enhance the quality of death certification require further consideration. Mandating a medical examiner system may not lead to intended improvements in the quality and cause of death data that form a critical component of mortality statistics that underpin health planning and monitoring.
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Affiliation(s)
| | | | - P Carder
- NHS West Yorkshire Integrated Care Board, UK
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Hovaguimian F, Beeler PE, Müllhaupt B, Günthard HF, Maeschli B, Bruggmann P, Fehr JS, Kouyos RD. Mortality and morbidity related to hepatitis C virus infection in hospitalized adults-A propensity score matched analysis. J Viral Hepat 2023; 30:765-774. [PMID: 37309273 DOI: 10.1111/jvh.13861] [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] [Received: 02/25/2023] [Revised: 05/01/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
The World Health Organization (WHO) aims to reduce HCV mortality, but estimates are difficult to obtain. We aimed to identify electronic health records of individuals with HCV infection, and assess mortality and morbidity. We applied electronic phenotyping strategies on routinely collected data from patients hospitalized at a tertiary referral hospital in Switzerland between 2009 and 2017. Individuals with HCV infection were identified using International Classification of Disease (ICD)-10 codes, prescribed medications and laboratory results (antibody, PCR, antigen or genotype test). Controls were selected using propensity score methods (matching by age, sex, intravenous drug use, alcohol abuse and HIV co-infection). Main outcomes were in-hospital mortality and attributable mortality (in HCV cases and study population). The non-matched dataset included records from 165,972 individuals (287,255 hospital stays). Electronic phenotyping identified 2285 stays with evidence of HCV infection (1677 individuals). Propensity score matching yielded 6855 stays (2285 with HCV, 4570 controls). In-hospital mortality was higher in HCV cases (RR 2.10, 95%CI 1.64 to 2.70). Among those infected, 52.5% of the deaths were attributable to HCV (95%CI 38.9 to 63.1). When cases were matched, the fraction of deaths attributable to HCV was 26.9% (HCV prevalence: 33%), whilst in the non-matched dataset, it was 0.92% (HCV prevalence: 0.8%). In this study, HCV infection was strongly associated with increased mortality. Our methodology may be used to monitor the efforts towards meeting the WHO elimination targets and underline the importance of electronic cohorts as a basis for national longitudinal surveillance.
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Affiliation(s)
- Frédérique Hovaguimian
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Patrick E Beeler
- Division of Occupational and Environmental Medicine, Epidemiology, Biostatistics and Prevention Institute, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland
| | - Beat Müllhaupt
- Department of Gastroenterology and Hepatology, University Hospital of Zurich, Zurich, Switzerland
| | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Philip Bruggmann
- Swiss Hepatitis, Zurich, Switzerland
- Arud Centre for Addiction Medicine, Zurich, Switzerland
| | - Jan S Fehr
- Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
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Madadin M. Medical Students’ Knowledge of the Cause-of-Death Certification: A Descriptive, Cross-Sectional Study from Saudi Arabia. Int J Gen Med 2021; 14:9663-9669. [PMID: 34934343 PMCID: PMC8684382 DOI: 10.2147/ijgm.s343787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background The medical certificate of cause-of-death is an important document of medicolegal significance. Errors in the completion of the death certificate by doctors are not uncommon. Therefore, it is important for medical students, the future doctors, to be trained in completing the medical certificate of cause-of-death. This study aimed to investigate the understanding of final-year medical students of the cause-of-death certification and to assess their ability to complete the cause-of-death statement. Material and Methods The final-year medical students of Imam Abdulrahman Bin Faisal University, of the academic year 2020–21 formed the cohort of medical students that participated in the current descriptive, cross-sectional study wherein a self-administered online questionnaire was used. Results A total of 174 students provided complete responses. The immediate cause of death in the given case scenario was answered correctly by 107 (61.5%) of the students. The underlying cause of death was answered correctly by only 20 (11.5%) students. It was apparent that the chain of events leading to death in the given case scenario was wrongly understood by the majority of the students. Nonetheless, the other significant condition contributing to death was answered correctly by 151 (86.8%) students. Other errors included the use of abbreviations, mention of the mechanism of death as a cause of death, mention of clinical features or irrelevant causes of death and mention of the incorrect time interval between the onset of a cause of death and death. Conclusion The current study found that the overall performance of final-year medical students was reasonably good except for the fact that most misunderstood the underlying cause of death in the given case scenario. The majority of the students had attended a tutorial on medical certification of cause-of-death before participating in the current study, which suggests that continuous training might be required.
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Affiliation(s)
- Mohammed Madadin
- Department of Pathology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Correspondence: Mohammed Madadin Department of Pathology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, 34211, Saudi ArabiaTel +966 13 3333766; +966504997673Fax +966 13 3330333 Email
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