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Mirnezami AH, Drami I, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Denys A, Pape E, van Ramshorst GH, Baker D, Bignall E, Blair I, Davis P, Edwards T, Jackson K, Leendertse PG, Love-Mott E, MacKenzie L, Martens F, Meredith D, Nettleton SE, Trotman MP, van Hecke JJM, Weemaes AMJ, Abecasis N, Angenete E, Aziz O, Bacalbasa N, Barton D, Baseckas G, Beggs A, Brown K, Buchwald P, Burling D, Burns E, Caycedo-Marulanda A, Chang GJ, Coyne PE, Croner RS, Daniels IR, Denost QD, Drozdov E, Eglinton T, Espín-Basany E, Evans MD, Flatmark K, Folkesson J, Frizelle FA, Gallego MA, Gil-Moreno A, Goffredo P, Griffiths B, Gwenaël F, Harris DA, Iversen LH, Kandaswamy GV, Kazi M, Kelly ME, Kokelaar R, Kusters M, Langheinrich MC, Larach T, Lydrup ML, Lyons A, Mann C, McDermott FD, Monson JRT, Neeff H, Negoi I, Ng JL, Nicolaou M, Palmer G, Parnaby C, Pellino G, Peterson AC, Quyn A, Rogers A, Rothbarth J, Abu Saadeh F, Saklani A, Sammour T, Sayyed R, Smart NJ, Smith T, Sorrentino L, Steele SR, Stitzenberg K, Taylor C, Teras J, Thanapal MR, Thorgersen E, Vasquez-Jimenez W, Waller J, Weber K, Wolthuis A, Winter DC, Brangan G, Vimalachandran D, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Baker RP, Bali M, Baransi S, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Bui A, Burgess A, Burger JWA, Campain N, Carvalhal S, Castro L, Ceelen W, Chan KKL, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Damjanovic L, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Egger E, Enrique-Navascues JM, Espín-Basany E, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Fleming F, Flor B, Foskett K, Funder J, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Giner F, Ginther N, Glover T, Golda T, Gomez CM, Harris C, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Jenkins JT, Jourand K, Kaffenberger S, Kapur S, Kanemitsu Y, Kaufman M, Kelley SR, Keller DS, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Lago V, Lakkis Z, Lampe B, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lynch AC, Mackintosh M, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Morton JR, Mullaney TG, Navarro AS, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Pappou E, Park J, Patsouras D, Peacock O, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steffens D, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor D, Tejedor P, Tekin A, Tekkis PP, Thaysen HV, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Yano H, Yip B, Yip J, Yoo RN, Zappa MA. The empty pelvis syndrome: a core data set from the PelvEx collaborative. Br J Surg 2024; 111:znae042. [PMID: 38456677 PMCID: PMC10921833 DOI: 10.1093/bjs/znae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurable core outcome set, core descriptor set and written definition for EPS. Consensus on strategies to mitigate EPS was also explored. METHOD Three-stage consensus methodology was used: longlisting with systematic review, healthcare professional event, patient engagement, and Delphi-piloting; shortlisting with two rounds of modified Delphi; and a confirmatory stage using a modified nominal group technique. This included a selection of measurement instruments, and iterative generation of a written EPS definition. RESULTS One hundred and three and 119 participants took part in the modified Delphi and consensus meetings, respectively. This encompassed international patient and healthcare professional representation with multidisciplinary input. Seventy statements were longlisted, seven core outcomes (bowel obstruction, enteroperineal fistula, chronic perineal sinus, infected pelvic collection, bowel obstruction, morbidity from reconstruction, re-intervention, and quality of life), and four core descriptors (magnitude of surgery, radiotherapy-induced damage, methods of reconstruction, and changes in volume of pelvic dead space) reached consensus-where applicable, measurement of these outcomes and descriptors was defined. A written definition for EPS was agreed. CONCLUSIONS EPS is an area of unmet research and clinical need. This study provides an agreed definition and core data set for EPS to facilitate further research.
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West CT, West MA, Mirnezami AH, Drami I, Denys A, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Pape E, van Ramshorst GH, Aalbers AGJ, Abdul AN, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Angenete E, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brown K, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelen W, Chan KKL, Chang GJ, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Denost QD, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Egger E, Eglinton T, Enrique-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Flatmark K, Fleming F, Flor B, Folkesson J, Foskett K, Frizelle FA, Funder J, Gallego MA, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther N, Glover T, Goffredo P, Golda T, Gomez CM, Griffiths B, Gwenaël F, Harris C, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kaufman M, Kazi M, Kelley SR, Keller DS, Kelly ME, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Kusters M, Lago V, Lakkis Z, Lampe B, Langheinrich MC, Larach T, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Mackintosh M, Mann C, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McDermott FD, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Monson JRT, Morton JR, Mullaney TG, Navarro AS, Neeff H, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock A, Pellino G, Peterson AC, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Quyn A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Smith T, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor C, Taylor D, Tejedor P, Tekin A, Tekkis PP, Teras J, Thanapal MR, Thaysen HV, Thorgersen E, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Empty pelvis syndrome: PelvEx Collaborative guideline proposal. Br J Surg 2023; 110:1730-1731. [PMID: 37757457 PMCID: PMC10805575 DOI: 10.1093/bjs/znad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
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Benara SK, Sharma S, Juneja A, Nair S, Gulati BK, Singh KJ, Singh L, Yadav VP, Rao C, Rao MVV. Evaluation of methods for assigning causes of death from verbal autopsies in India. Front Big Data 2023; 6:1197471. [PMID: 37693847 PMCID: PMC10483407 DOI: 10.3389/fdata.2023.1197471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Background Physician-coded verbal autopsy (PCVA) is the most widely used method to determine causes of death (COD) in countries where medical certification of death is low. Computer-coded verbal autopsy (CCVA), an alternative method to PCVA for assigning the COD is considered to be efficient and cost-effective. However, the performance of CCVA as compared to PCVA is yet to be established in the Indian context. Methods We evaluated the performance of PCVA and three CCVA methods i.e., InterVA 5, InSilico, and Tariff 2.0 on verbal autopsies done using the WHO 2016 VA tool on 2,120 reference standard cases developed from five tertiary care hospitals of Delhi. PCVA methodology involved dual independent review with adjudication, where required. Metrics to assess performance were Cause Specific Mortality Fraction (CSMF), sensitivity, positive predictive value (PPV), CSMF Accuracy, and Kappa statistic. Results In terms of the measures of the overall performance of COD assignment methods, for CSMF Accuracy, the PCVA method achieved the highest score of 0.79, followed by 0.67 for Tariff_2.0, 0.66 for Inter-VA and 0.62 for InSilicoVA. The PCVA method also achieved the highest agreement (57%) and Kappa scores (0.54). The PCVA method showed the highest sensitivity for 15 out of 20 causes of death. Conclusion Our study found that the PCVA method had the best performance out of all the four COD assignment methods that were tested in our study sample. In order to improve the performance of CCVA methods, multicentric studies with larger sample sizes need to be conducted using the WHO VA tool.
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Affiliation(s)
- Sudhir K. Benara
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | - Saurabh Sharma
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | - Atul Juneja
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | - Saritha Nair
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | - B. K. Gulati
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | - Kh. Jitenkumar Singh
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | - Lucky Singh
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | | | - Chalapati Rao
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - M. Vishnu Vardhana Rao
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
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Gupta M, Rao C, Yadav AK, Jat M, Dhamija RK, Saikia N. The COVID-19 pandemic death toll in India: can we know better? BMJ Glob Health 2023; 8:e012818. [PMID: 37643805 PMCID: PMC10465911 DOI: 10.1136/bmjgh-2023-012818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023] Open
Affiliation(s)
- M Gupta
- Alchemist Research and Data Analysis, Chandigarh, India
| | - Chalapati Rao
- Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Munita Jat
- Alchemist Research and Data Analysis, Chandigarh, India
| | - Rajinder K Dhamija
- Institute of Human Behaviour and Allied Sciences, New Delhi, Delhi, India
| | - Nandita Saikia
- International Institute for Population Sciences, Mumbai, Maharashtra, India
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Musadad DA, Angkasawati TJ, Usman Y, Kelly M, Rao C. Implementation research for developing Civil Registration and Vital Statistics (CRVS) Systems: lessons from Indonesia. BMJ Glob Health 2023; 8:e012358. [PMID: 37474276 PMCID: PMC10360419 DOI: 10.1136/bmjgh-2023-012358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/29/2023] [Indexed: 07/22/2023] Open
Abstract
Civil Registration and Vital Statistics (CRVS) systems are the optimal source for data on births, deaths and causes of death for health policy, programme evaluation and research. In Indonesia, indicators such as life expectancy at birth, childhood and maternal mortality rates and cause-specific death rates need to be routinely monitored for national health policy. However, the CRVS system is not yet producing reliable vital statistics, which creates a challenge for evidence-based health action. In 2019, the Indonesian government released a national strategy for the CRVS system, with targets for improved coverage and data quality by 2024. This article describes findings from a programme of formative and implementation research to guide the application of the national strategy. At first, a detailed CRVS assessment and gap analysis were undertaken using an international framework. The assessment findings were used to develop a revised business process model for reporting deaths and their causes at village, subdistrict and district level. In addition, a field instruction manual was also developed to guide personnel in implementation. Two field sites in Java-Malang District and Kudus Regency were selected for pilot testing the reporting procedures, and relevant site preparation and training were carried out. Data compilations for Malang in 2019 and Kudus in 2020 were analysed to derive mortality indicators. High levels of death reporting completeness (83% to 89%) were reported from both districts, along with plausible cause-specific mortality profiles, although the latter need further validation. The study findings establish the feasibility of implementing revised death reporting procedures at the local level, as well as demonstrate sustainability through institutionalisation and capacity building, and can be used to accelerate further development of the CRVS system in Indonesia.
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Affiliation(s)
- Dede Anwar Musadad
- Health Research Organization, National Research and Innovation Agency Republic of Indonesia, Jakarta Pusat, Indonesia
| | - Tri Juni Angkasawati
- Center for Health Financing and Decentralization Policy, Ministry of Health, Jakarta, Indonesia
| | - Yuslely Usman
- Center for Health Financing and Decentralization Policy, Ministry of Health, Republic of Indonesia, Jakarta, Indonesia
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Chalapati Rao
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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Bishop K, Balogun S, Eynstone-Hinkins J, Moran L, Martin M, Banks E, Rao C, Joshy G. Analysis of Multiple Causes of Death: A Review of Methods and Practices. Epidemiology 2023; 34:333-344. [PMID: 36719759 PMCID: PMC10069753 DOI: 10.1097/ede.0000000000001597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/27/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Research and reporting of mortality indicators typically focus on a single underlying cause of death selected from multiple causes recorded on a death certificate. The need to incorporate the multiple causes in mortality statistics-reflecting increasing multimorbidity and complex causation patterns-is recognized internationally. This review aims to identify and appraise relevant analytical methods and practices related to multiple causes. METHODS We searched Medline, PubMed, Scopus, and Web of Science from their incept ion to December 2020 without language restrictions, supplemented by consultation with international experts. Eligible articles analyzed multiple causes of death from death certificates. The process identified 4,080 items of which we reviewed 434 full-text articles. RESULTS Most articles we reviewed (76%, n = 332) were published since 2001. The majority of articles examined mortality by "any- mention" of the cause of death (87%, n = 377) and assessed pairwise combinations of causes (57%, n = 245). Since 2001, applications of methods emerged to group deaths based on common cause patterns using, for example, cluster analysis (2%, n = 9), and application of multiple-cause weights to re-evaluate mortality burden (1%, n = 5). We describe multiple-cause methods applied to specific research objectives for approaches emerging recently. CONCLUSION This review confirms rapidly increasing international interest in the analysis of multiple causes of death and provides the most comprehensive overview, to our knowledge, of methods and practices to date. Available multiple-cause methods are diverse but suit a range of research objectives. With greater availability of data and technology, these could be further developed and applied across a range of settings.
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Affiliation(s)
- Karen Bishop
- From the National Centre for Epidemiology and Population Health, Australian National University
| | - Saliu Balogun
- From the National Centre for Epidemiology and Population Health, Australian National University
| | | | - Lauren Moran
- Australian Bureau of Statistics, Canberra, Australia
| | - Melonie Martin
- From the National Centre for Epidemiology and Population Health, Australian National University
| | - Emily Banks
- From the National Centre for Epidemiology and Population Health, Australian National University
| | - Chalapati Rao
- From the National Centre for Epidemiology and Population Health, Australian National University
| | - Grace Joshy
- From the National Centre for Epidemiology and Population Health, Australian National University
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Bibi S, Edilbe MW, Rao C. The Cost-effectiveness of Watch and Wait for Rectal Cancer. Clin Oncol (R Coll Radiol) 2023; 35:132-137. [PMID: 36266161 DOI: 10.1016/j.clon.2022.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/25/2022] [Accepted: 10/03/2022] [Indexed: 01/18/2023]
Abstract
The existing literature suggests with a high degree of certainty that watch and wait is more cost-effective than initial total mesorectal excision. However, it is heavily reliant on poor-quality health-related quality of life data. Furthermore, the cost-effectiveness of organ preservation from a broader societal perspective has not been studied. Finally, the cost-effectiveness of emerging adjuncts to watch and wait for organ preservation, such as contact X-ray brachytherapy, local excision and total neoadjuvant therapy, need to be characterised.
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Affiliation(s)
- S Bibi
- The Department of Colorectal Surgery, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK
| | - M W Edilbe
- The Department of Colorectal Surgery, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK; The Academic Surgical Unit, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK
| | - C Rao
- The Academic Surgical Unit, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK; The Department of Surgery and Cancer, Imperial College, London, UK.
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Fahy MR, Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angeles MA, Angenete E, Antoniou A, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Beynon J, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelan W, Chan KKL, Chang GJ, Chang M, Chew MH, Chok AY, Chong P, Clouston H, Codd M, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovich L, Daniels IR, Davies M, Delaney CP, de Wilt JHW, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Eglinton T, Enriquez-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fearnhead NS, Ferron G, Flatmark K, Fleming FJ, Flor B, Folkesson J, Frizelle FA, Funder J, Gallego MA, Gargiulo M, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther DN, Glyn T, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kazi M, Kelley SR, Keller DS, Ketelaers SHJ, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kristensen HØ, Kroon HM, Kumar S, Kusters M, Lago V, Lampe B, Lakkis Z, Larach JT, Larkin JO, Larsen SG, Larson DW, Law WL, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Maciel J, Manfredelli S, Mann C, Mantyh C, Mathis KL, Marques CFS, Martinez A, Martling A, Mehigan BJ, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, Mikalauskas S, McArthur DR, McCormick JJ, McCormick P, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Navarro AS, Negoi I, Neto JWM, Ng JL, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, Nugent T, Oliver A, O’Dwyer ST, O’Sullivan NJ, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock O, Pellino G, Peterson AC, Pinson J, Poggioli G, Proud D, Quinn M, Quyn A, Rajendran N, Radwan RW, Rajendran N, Rao C, Rasheed S, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Selvasekar C, Shaikh I, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Sorrentino L, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Spasojevic M, Sumrien H, Sutton PA, Swartking T, Takala H, Tan EJ, Taylor C, Tekin A, Tekkis PP, Teras J, Thaysen HV, Thurairaja R, Thorgersen EB, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Valente M, van Ramshorst GH, van Zoggel D, Vasquez-Jimenez W, Vather R, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Urrejola G, Wakeman C, Warrier SK, Wasmuth HH, Waters PS, Weber K, Weiser MR, Wheeler JMD, Wild J, Williams A, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Minimum standards of pelvic exenterative practice: PelvEx Collaborative guideline. Br J Surg 2022; 109:1251-1263. [PMID: 36170347 DOI: 10.1093/bjs/znac317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 12/31/2022]
Abstract
This document outlines the important aspects of caring for patients who have been diagnosed with advanced pelvic cancer. It is primarily aimed at those who are establishing a service that adequately caters to this patient group. The relevant literature has been summarized and an attempt made to simplify the approach to management of these complex cases.
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Sun Myint A, Dhadda A, Stewart A, Mills J, Sripadam R, Rao C, Hunter A, Hershman M, Franklin A, Chadwick E, Banerjee A, Rockall T, Pritchard D, Gerard J. The Role of Contact X-Ray Brachytherapy in Early Rectal Cancer – Who, when and How? Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Fang Y, Pan H, Shou J, Chen J, Guo Q, Hong W, Rao C, Wang Y, Lu L, Yang X, Zhu D, Lan F. 1036P Anlotinib plus docetaxel vs. docetaxel as 2nd-line treatment of advanced non-small cell lung cancer (NSCLC): Updated results from ALTER-L016. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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12
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Bishop K, Moreno-Betancur M, Balogun S, Eynstone-Hinkins J, Moran L, Rao C, Banks E, Korda RJ, Gourley M, Joshy G. Quantifying cause-related mortality in Australia, incorporating multiple causes: observed patterns, trends and practical considerations. Int J Epidemiol 2022; 52:284-294. [PMID: 35984318 PMCID: PMC9908048 DOI: 10.1093/ije/dyac167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mortality statistics using a single underlying cause of death (UC) are key health indicators. Rising multimorbidity and chronic disease mean that deaths increasingly involve multiple conditions. However, additional causes reported on death certificates are rarely integrated into mortality indicators, partly due to complexities in data and methods. This study aimed to assess trends and patterns in cause-related mortality in Australia, integrating multiple causes (MC) of death. METHODS Deaths (n = 1 773 399) in Australia (2006-17) were mapped to 136 ICD-10-based groups and MC indicators applied. Age-standardized cause-related rates (deaths/100 000) based on the UC (ASRUC) were compared with rates based on any mention of the cause (ASRAM) using rate ratios (RR = ASRAM/ASRUC) and to rates based on weighting multiple contributing causes (ASRW). RESULTS Deaths involved on average 3.4 causes in 2017; the percentage with >4 causes increased from 20.9 (2006) to 24.4 (2017). Ischaemic heart disease (ASRUC = 73.3, ASRAM = 135.8, ASRW = 63.5), dementia (ASRUC = 51.1, ASRAM = 98.1, ASRW = 52.1) and cerebrovascular diseases (ASRUC = 39.9, ASRAM = 76.7, ASRW = 33.5) ranked as leading causes by all methods. Causes with high RR included hypertension (ASRUC = 2.2, RR = 35.5), atrial fibrillation (ASRUC = 8.0, RR = 6.5) and diabetes (ASRUC = 18.5, RR = 3.5); the corresponding ASRW were 12.5, 12.6 and 24.0, respectively. Renal failure, atrial fibrillation and hypertension ranked among the 10 leading causes by ASRAM and ASRW but not by ASRUC. Practical considerations in working with MC data are discussed. CONCLUSIONS Despite the similarities in leading causes under the three methods, with integration of MC several preventable diseases emerged as leading causes. MC analyses offer a richer additional perspective for population health monitoring and policy development.
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Affiliation(s)
- Karen Bishop
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Margarita Moreno-Betancur
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, VIC, Australia,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Saliu Balogun
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - James Eynstone-Hinkins
- Health and Vital Statistics Section, Australian Bureau of Statistics, Canberra, ACT, Australia
| | - Lauren Moran
- Health and Vital Statistics Section, Australian Bureau of Statistics, Canberra, ACT, Australia
| | - Chalapati Rao
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Rosemary J Korda
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Michelle Gourley
- Population Health Group, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Grace Joshy
- Corresponding author. National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, 62 Mills Road, Acton ACT 2601, Australia. E-mail:
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13
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Pham BN, Abori N, Silas VD, Jorry R, Rao C, Okely T, Pomat W. Tuberculosis and HIV/AIDS-attributed mortalities and associated sociodemographic factors in Papua New Guinea: evidence from the comprehensive health and epidemiological surveillance system. BMJ Open 2022; 12:e058962. [PMID: 35772818 PMCID: PMC9247692 DOI: 10.1136/bmjopen-2021-058962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Tuberculosis (TB) and HIV/AIDS are public health concerns in Papua New Guinea (PNG). This study examines TB and HIV/AIDS mortalities and associated sociodemographic factors in PNG. METHOD As part of a longitudinal study, verbal autopsy (VA) interviews were conducted using the WHO 2016 VA Instrument to collect data of 926 deaths occurred in the communities within the catchment areas of the Comprehensive Health and Epidemiological Surveillance System from 2018 to 2020.InterVA-5 cause of deaths analytical tool was used to assign specific causes of death (COD). Multinomial logistic regression analyses were conducted to identify associated sociodemographic factors, estimate adjusted ORs (AOR), 95% CIs and p values. RESULT TB and HIV/AIDS were the leading CODs from infectious diseases, attributed to 9% and 8% of the total deaths, respectively.Young adults (25-34 years) had the highest proportion of deaths from TB (20%) and the risk of dying from TB among this age group was five times more likely than those aged 75+ years (AOR: 5.5 (95% CI 1.4 to 21.7)). Urban populations were 46% less likely to die from this disease compared rural ones although the difference was not significant (AOR: 0.54 (95% CI 0.3 to 1.0)). People from middle household wealth quintile were three times more likely to die from TB than those in the richest quintile (AOR: 3.0 (95% CI 1.3 to 7.4)).Young adults also had the highest proportion of deaths to HIV/AIDS (18%) and were nearly seven times more likely to die from this disease compared with those aged 75+years (AOR: 6.7 (95% CI 1.7 to 25.4)). Males were 48% less likely to die from HIV/AIDS than females (AOR: 0.52 (95% CI 0.3 to 0.9)). The risk of dying from HIV/AIDS in urban population was 54% less likely than their rural counterparts (AOR: 0.46 (95% CI 0.2 to 0.9)). CONCLUSION TB and HIV/AIDS interventions are needed to target vulnerable populations to reduce premature mortality from these diseases in PNG.
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Affiliation(s)
- Bang Nguyen Pham
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Norah Abori
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Vinson D Silas
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Ronny Jorry
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Chalapati Rao
- School of Population Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Tony Okely
- School of Health and Society, the University of Wollongong, Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Willie Pomat
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
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14
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Traverso A, Rao C, Briassouli A, Dekker A, De Ruysscher D, van Elmpt W. PO-1609 Generating synthetic hypoxia images from FDG-PET using Generative Adversarial Networks (GANs). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03573-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Rao C, John AJ, Yadav AK, Siraj M. Subnational mortality estimates for India in 2019: a baseline for evaluating excess deaths due to the COVID-19 pandemic. BMJ Glob Health 2021; 6:bmjgh-2021-007399. [PMID: 34824138 PMCID: PMC8627370 DOI: 10.1136/bmjgh-2021-007399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/27/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Estimates of excess mortality are required to assess and compare the impact of the COVID-19 pandemic across populations. For India, reliable baseline prepandemic mortality patterns at national and subnational level are necessary for such assessments. However, available data from the Civil Registration System (CRS) is affected by incompleteness of death recording that varies by sex, age and location. METHODS Under-reporting of CRS 2019 deaths was assessed for three age groups (< 5 years, 15-59 years and ≥60 years) at subnational level, through comparison with age-specific death rates from alternate sources. Age-specific corrections for under-reporting were applied to derive adjusted death counts by sex for each location. These were used to compute life expectancy (LE) at birth by sex in 2019, which were compared with subnational LEs from the Global Burden of Disease (GBD) 2019 Study. RESULTS A total of 9.92 million deaths (95% UI 9.70 to 10.02) were estimated across India in 2019, about 2.28 million more than CRS reports. Adjustments to under-five and elderly mortality accounted for 30% and 56% of additional deaths, respectively. Adjustments in Bihar, Jharkhand, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh accounted for 75% of all additional deaths. Adjusted LEs were below corresponding GBD estimates by ≥2 years for males at national level and in 20 states, and by ≥1 year for females in 12 states. CONCLUSIONS These results represent the first-ever subnational mortality estimates for India derived from CRS reported deaths, and serve as a baseline for assessing excess mortality from the COVID-19 pandemic. Adjusted life expectancies indicate higher mortality patterns in India than previously perceived. Under-reporting of infant deaths and those among women and the elderly is evident in many locations. Further CRS strengthening is required to improve the empirical basis for local mortality measurement across the country.
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Affiliation(s)
- Chalapati Rao
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Amrit Jose John
- International Institute for Population Sciences, Mumbai, India
| | - Ajit Kumar Yadav
- Indo German Programme on Universal Health Coverage, GIZ, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Delhi, India
| | - Mansha Siraj
- Goldman School of Public Policy, University of California Berkeley, Berkeley, California, USA
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16
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Rao C, Bundhamcharoen K, Kelly M, Tangcharoensathien V. Mortality estimates for WHO SEAR countries: problems and prospects. BMJ Glob Health 2021; 6:bmjgh-2021-007177. [PMID: 34728480 PMCID: PMC8568533 DOI: 10.1136/bmjgh-2021-007177] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/30/2021] [Indexed: 12/11/2022] Open
Abstract
Cause-specific mortality estimates for 11 countries located in the WHO’s South East Asia Region (WHO SEAR) are generated periodically by the Global Burden of Disease (GBD) and the WHO Global Health Estimates (GHE) analyses. A comparison of GBD and GHE estimates for 2019 for 11 specific causes of epidemiological importance to South East Asia was undertaken. An index of relative difference (RD) between the estimated numbers of deaths by sex for each cause from the two sources for each country was calculated, and categorised as marginal (RD=±0%–9%), moderate (RD=±10%–19%), high (RD=±20%–39%) and extreme (RD>±40%). The comparison identified that the RD was >10% in two-thirds of all instances. The RD was ‘high’ or ‘extreme’ for deaths from tuberculosis, diarrhoea, road injuries and suicide for most SEAR countries, and for deaths from most of the 11 causes in Bangladesh, DPR Korea, Myanmar, Nepal and Sri Lanka. For all WHO SEAR countries, mortality estimates from both sources are based on statistical models developed from an international historical cause-specific mortality data series that included very limited empirical data from the region. Also, there is no scientific rationale available to justify the reliability of one set of estimates over the other. The characteristics of national mortality statistics systems for each WHO SEAR country were analysed, to understand the reasons for weaknesses in empirical data. The systems analysis identified specific limitations in structure, organisation and implementation that affect data completeness, validity of causes of death and vital statistics production, which vary across countries. Therefore, customised national strategies are required to strengthen mortality statistics systems to meet immediate and long-term data needs for health policy and research, and reduce dependence on current unreliable modelled estimates.
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Affiliation(s)
- Chalapati Rao
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Matthew Kelly
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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17
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Bhandari M, Rao M, Bussa G, Rao C. 711 Effect of Roux-En-Y Gastric Bypass on HbA1c As Well As Number of Medications in Diabetic Patients. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
Roux en Y gastric bypass (RYGB) is known to ameliorate Type 2 Diabetes Mellitus (T2DM) in morbidly obese patients. We aimed to determine both the reduction in the glycosylated haemoglobin (HbA1c) and the number of anti-diabetic medications (including insulin) in diabetic patients undergoing RYGB over a five-year period.
Method
We reviewed data of diabetic patients (n = 530) who underwent RYGB from January 2012 – December 2017, including those with a minimum of a 2-year post-operative follow up (n = 47). Preoperatively, BMI, HbA1c and the number of anti-diabetic medications and the duration of T2DM since diagnosis were recorded. These measurements were repeated at the end of the two year follow up.
Results
At the time of enrolment in the bariatric programme, the median BMI was 42.5 (range, 31.7-61.5) kg/m2, mean duration of T2DM was 58 months and median HbA1c was 59 (37-118) mmol/mol. The mean number of anti-diabetic medications taken, including insulin, was 2. At the end of 2-year follow-up, the median BMI was 32 (range, 24-41) kg/m2 and HbA1c was 41(range, 33-91) mmol/mol. 15 patients (31.9%) still required anti-diabetic medication, 12 of whom had a diagnosis of T2DM for 3 years or more at time of enrolment.
Conclusions
RYGB is strongly associated with a resolution of T2DM in morbidly obese patients. In those who were not resolved, the number of anti-diabetic medications taken and HbA1c were reduced. The impact of the surgery is dependent on the duration of T2DM since diagnosis preoperatively.
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Affiliation(s)
- M Bhandari
- University Hospital of North Tees, Stockton On Tees, United Kingdom
| | - M Rao
- University Hospital of North Tees, Stockton On Tees, United Kingdom
| | - G Bussa
- University Hospital of North Tees, Stockton On Tees, United Kingdom
| | - C Rao
- Uniersity College London, London, United Kingdom
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18
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Bishop K, Balogun S, Eynston-Hinkins J, Moran L, Moreno-Betancur M, Korda R, Rao C, Banks E, Joshy G. 923Quantifying multiple causes of death: Observed patterns in Australia, 2006–2017. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Four fifths of deaths in Australia involve multiple causes, but statistics typically use a single underlying cause of death (UC). The UC approach alone is insufficient for understanding the impact of non-underlying causes and identifying comorbid disease associations at death. Analysis of multiple causes of death (MC) is needed to measure the impact of all causes. We described MC patterns, considering cause-of-death coding and certification practices in Australia.
Methods
Using deaths registered in Australia from 2006 to 2017 (n = 1773525) coded to the International Classification of Diseases (ICD) and an extended classification (n = 136 causes) based on a World Health Organization short list, we described MCoD data by cause. Age-standardised rates based on UC and MC were compared using the standardised ratio of multiple to underlying causes (SRMU) to estimate the contribution of the cause to mortality compared to using the UC approach. Comorbidity was explored using the cause of death association indicator (CDAI) to compare the observed joint frequency of a contributory-underlying cause combined with expected frequency of the contributory cause (with any UC).
Results
On average 3.4 conditions caused each death and 24.4% of deaths had 5 plus causes. Largest SRMUs were for genitourinary diseases (8.0), blood diseases (7.8) and musculoskeletal conditions (6.7). CDAIs showed high associations between, for example, accidental alcohol and opioid poisoning, septicaemia and skin infections, and traumatic brain injury and falls.
Conclusions
MC indicators enhance measures of mortality and reassess the role of causes of death for descriptive and analytical epidemiology.
Key messages
This research demonstrates the value of MC analysis for Australian mortality data.
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Affiliation(s)
- Karen Bishop
- Australian National University, Acton, Australia
| | | | | | - Lauren Moran
- Australian Bureau of Statistics, Canberra, Australia
| | - Margarita Moreno-Betancur
- Murdoch Children’s Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | | | | | - Emily Banks
- Australian National University, Acton, Australia
- Sax Institute, Sydney, Australia
| | - Grace Joshy
- Australian National University, Acton, Australia
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19
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Joshy G, Bishop K, Balogun S, Moreno-Betancur M, Eynstone-Hinkins J, Moran L, Korda R, Rao C, Banks E. 892Quantification of mortality incorporating multiple causes of death: Application of weighting strategies to Australian data. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mortality statistics are typically based on a single underlying cause of death (UCoD). Although UCoD provides a useful construct, the relevance of assuming that a single disease caused the death is diminishing, especially with increased life expectancy and high proportions of deaths in older ages from chronic/degenerative diseases. Focussing on common underlying causes of death in Australia, we quantified mortality incorporating weighting strategies for multiple causes of death (MCoD).
Methods
All deaths registered in Australia from 2015-2017 (478,396 deaths) and coded using International Classification of Diseases Version 10 were classified using an extended cause list (n = 136 causes) based on a World Health Organization short list. Age-standardised rates (ASR) were estimated using three weighting methods: (1) traditional approach using UCoD alone; (2) UCoD and associated causes of death (ACoDs) equally weighted and (3) UCoD weighted 0.5 arbitrarily and remaining 0.5 apportioned to the remaining ACoDs.
Results
Common UCoD were ischaemic heart diseases, cerebrovascular diseases, dementia; 57671, 31515 and 27377 deaths respectively. There were substantial changes in ASR depending on the weighting method used. Variation in mortality patterns estimated using the three weighting methods and challenges to further refinement of the weighting strategy will be discussed.
Conclusions
Mortality indicators incorporating MCoD enhance traditional measures of mortality and provide a means to reassess the role of diseases in causing death. Further disease specific methods are required to refine current weighting strategies.
Key messages
Weighting strategies for are useful for quantifying mortality incorporating MCoD, but methodological challenges exist.
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Affiliation(s)
- Grace Joshy
- Australian National University, Canberra, Australia
| | - Karen Bishop
- Australian National University, Canberra, Australia
| | | | - Margarita Moreno-Betancur
- Murdoch Children’s Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | | | - Lauren Moran
- Australian Bureau of Statistics, Canberra, Australia
| | | | | | - Emily Banks
- Australian National University, Canberra, Australia
- Sax Institute, Sydney, Australia
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20
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Balogun S, Bishop K, Eynstone-Hinkins J, Martin M, Moreno-Betancur M, Rao C, Joshy G. 1000Quantifying multiple causes of death: A systematic review and audit of methods and practice. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Mortality reporting and research are typically focused on a single underlying cause of death (UCoD) selected from multiple reported causes. The need to incorporate multiple causes of death (MCoD) in mortality statistics is now recognised internationally, but there is scant methodological work to guide analytical approaches. This review aims to identify and appraise current methods and practices used to analyse MCoD data.
Methods
The Web of Science, Medline, Pubmed and Scopus (from inception to December 2019) were queried. Studies reporting MCoD alone or in comparison with single UCoD were included. The review is supplemented by qualitative interview with international experts.
Results
3491 studies were identified; 141 full texts were included in the review. The measures usually estimated when analysing MCoD can be broadly categorised into descriptive measures (n = 93 studies), measures of associations between diseases (n = 46 studies) and advanced statistical methods (n = 11 studies). Descriptive statistics commonly used include standardized ratio of multiple to underlying cause (SRMU) and mortality rates based on any mention of a disease. Approaches used to assess measures of associations between diseases include the Cause-of-Death Association Indicator (CDAI) and social network analysis. The advanced statistical methods include weighting MCoD and lethal defect-wear model of mortality. Audit results will be discussed.
Conclusions
This review provides a comprehensive and updated summary of methodological approaches used to analyse MCoD data. The merit of each analytical framework is discussed.
Key messages
More work is needed to develop methodological frameworks that could be used to support routine consideration of MCoD in practice.
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Affiliation(s)
- Saliu Balogun
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Karen Bishop
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | | | - Melonie Martin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Margarita Moreno-Betancur
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Chalapati Rao
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Grace Joshy
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
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21
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Kaul S, Rao C, Mane R, Tan KL, Khan AHA, Hussain MS, Shafi MA, Buettner F, Banerjee S, Boulton R, Bhargava A, Huang J, Hanson M, Raouf S, Ball S, Rajendran N. Is the Management of Rectal Cancer Using a Watch and Wait Approach Feasible, Safe and Effective in a Publicly Funded General Hospital? Clin Oncol (R Coll Radiol) 2021; 34:e25-e34. [PMID: 34454807 DOI: 10.1016/j.clon.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/03/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
AIMS Although there is emerging evidence to suggest equivalent oncological outcomes using a watch and wait approach compared with primary total mesorectal excision surgery, there is a paucity of evidence about the safety and efficacy of this approach in routine clinical practice. Here we report the long-term outcomes and quality of life from patients managed with watch and wait following a clinical complete response (cCR) to neoadjuvant therapy. MATERIALS AND METHODS Patients with adenocarcinoma of the rectum with cCR following neoadjuvant therapy managed using watch and wait were retrospectively identified. Demographic data, performance status, pretreatment staging information, oncological and surgical outcomes were obtained from routinely collected clinical data. Quality of life was measured by trained clinicians during telephone interviews. RESULTS Over a 7-year period, 506 patients were treated for rectal cancer, 276 had neoadjuvant therapy and 72 had a cCR (26.1%). Sixty-three were managed with watch and wait. Thirteen patients had mucosal regrowth. There was no significant difference in the incidence of metastatic disease between the surgical and watch and wait cohorts (P = 0.38). The 13 patients with mucosal regrowth underwent salvage surgery. Eleven of the patients who underwent surgical resection had R0 resections. There was also a statistically and clinically significant improvement in the Functional Assessment of Cancer Therapy - Colorectal (FACT-C) trial outcome index (P = 0.022). CONCLUSION This study shows that watch and wait is safe and effective outside of tertiary referral centres. It suggests that an opportunistic cCR is durable and when mucosal regrowth occurs it can be salvaged. Finally, we have shown that quality of life is probably improved if a watch and wait approach is adopted.
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Affiliation(s)
- S Kaul
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - C Rao
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK; Department of Surgery and Cancer, Imperial College London, London, UK; North Cumbria Integrated Care NHS Foundation Trust, UK.
| | - R Mane
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - K L Tan
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - A H A Khan
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - M S Hussain
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - M A Shafi
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - F Buettner
- German Cancer Consortium (DKTK), Heidelberg, Germany; German Cancer Research Centre (DKFZ), Heidelberg, Germany; Department of Medicine, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - S Banerjee
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - R Boulton
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - A Bhargava
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK; Institute of Health, Barts and London Medical School, Queen Mary University of London (QMUL), London, UK
| | - J Huang
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - M Hanson
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - S Raouf
- Barts Health NHS Trust, London, UK
| | - S Ball
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - N Rajendran
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK.
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22
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Deputy M, Rao C, Worley G, Balinskaite V, Bottle A, Aylin P, Burns EM, Faiz O. Effect of the SARS-CoV-2 pandemic on mortality related to high-risk emergency and major elective surgery. Br J Surg 2021; 108:754-759. [PMID: 33742195 PMCID: PMC8083782 DOI: 10.1093/bjs/znab029] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 11/23/2022]
Abstract
These data show large reductions in both elective and emergency activity that are concerning for unmeasured morbidity and mortality within the community. The risk of mortality following high-risk EGS and major elective surgery during the first wave of the pandemic did not differ when compared with date-matched patient cohorts from 2019. The prevalence of concomitant SARS-CoV-2 infection in this surgical population is low.
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Affiliation(s)
- M Deputy
- Surgical Epidemiology, Trials and Outcome Centre, St Mark's Hospital and Academic Institute, Harrow, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - C Rao
- Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Colorectal Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - G Worley
- Surgical Epidemiology, Trials and Outcome Centre, St Mark's Hospital and Academic Institute, Harrow, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - V Balinskaite
- Dr Foster Unit, School of Public Health, Imperial College London, London, UK
| | - A Bottle
- Dr Foster Unit, School of Public Health, Imperial College London, London, UK
| | - P Aylin
- Dr Foster Unit, School of Public Health, Imperial College London, London, UK
| | - E M Burns
- Surgical Epidemiology, Trials and Outcome Centre, St Mark's Hospital and Academic Institute, Harrow, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - O Faiz
- Surgical Epidemiology, Trials and Outcome Centre, St Mark's Hospital and Academic Institute, Harrow, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
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23
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Rao C, Gupta A, Gupta M, Yadav AK. Premature adult mortality in India: what is the size of the matter? BMJ Glob Health 2021; 6:bmjgh-2020-004451. [PMID: 34135070 PMCID: PMC8211056 DOI: 10.1136/bmjgh-2020-004451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 05/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background Reducing adult mortality by 2030 is a key component of the United Nations Sustainable Development Goals (UNSDGs). Monitoring progress towards these goals requires timely and reliable information on deaths by age, sex and cause. To estimate baseline measures for UNSDGs, this study aimed to use several different data sources to estimate subnational measures of premature adult mortality (between 30 and 70 years) for India in 2017. Methods Age-specific population and mortality data were accessed for India and its 21 larger states from the Civil Registration System and Sample Registration System for 2017, and the most recent National Family and Health Survey. Similar data on population and deaths were also procured from the Global Burden of Disease Study 2016 and the National Burden of Disease Estimates Study for 2017. Life table methods were used to estimate life expectancy and age-specific mortality at national and state level from each source. An additional set of life tables were estimated using an international two-parameter model life table system. Three indicators of premature adult mortality were derived by sex for each location and from each data source, for comparative analysis Results Marked variations in mortality estimates from different sources were noted for each state. Assuming the highest mortality level from all sources as the potentially true value, premature adult mortality was estimated to cause a national total of 2.6 million male and 1.8 million female deaths in 2017, with Bihar, Maharashtra, Tamil Nadu, Uttar Pradesh and West Bengal accounting for half of these deaths. There was marked heterogeneity in risk of premature adult mortality, ranging from 351 per 1000 in Kerala to 558 per 1000 in Chhattisgarh among men, and from 198 per 1000 in Himachal Pradesh to 409 per 1000 in Assam among women. Conclusions Available data and estimates for mortality measurement in India are riddled with uncertainty. While the findings from this analysis may be useful for initial subnational health policy to address UNSDGs, more reliable empirical data is required for monitoring and evaluation. For this, strengthening death registration, improving methods for cause of death ascertainment and establishment of robust mortality statistics programs are a priority.
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Affiliation(s)
- Chalapati Rao
- Research School of Population Health, Australian National University College of Medicine Biology and Environment, Canberra, Australian Capital Territory, Australia
| | - Aashish Gupta
- Demography and Sociology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mamta Gupta
- Alchemist Research and Data Analysis, Chandigarh, India
| | - Ajit Kumar Yadav
- Gender research project, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Rao C, Kelly M. Empiricism in non-communicable disease mortality measurement for the Asia-Pacific: lost in translation. BMJ Glob Health 2021; 5:bmjgh-2020-003626. [PMID: 33199279 PMCID: PMC7670854 DOI: 10.1136/bmjgh-2020-003626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022] Open
Abstract
Control of non-communicable diseases (NCDs) is a key target for the United Nations Sustainable Development Goals (SDGs) for 2030. Available information indicates that countries in the Asia-Pacific Region accounted for 63% of the global NCD mortality burden in 2016. The United Nations Economic and Social Commission for the Asia Pacific (UNESCAP) Regional SDG progress report for 2020 included estimates of trends in NCD mortality rates from 2000 to 2016, which showed considerable variation in national NCD mortality by sex and location. However, while the UNESCAP report states that there was sufficient primary data to derive these NCD mortality estimates for all countries, the critical gaps in availability of national data on causes of death in the Asia-Pacific region are well known. A closer review identified that the UNESCAP obtained these estimates from the United Nations Statistics Division, which in turn obtained the same estimates from WHO. Further analysis revealed that these organisations used varying and often inconsistent terms to describe estimation methodology as well as primary data availability for different countries, with substantial potential for misinterpretation. The analysis also found that for countries without primary data, WHO reported NCD mortality estimates were based on complex epidemiological models developed for the Global Burden of Disease (GBD) Study, and this contradicts the UNESCAP rating of primary data sufficiency. The GBD Study also derives modelled cause of death estimates for countries with national data, but these were different from WHO estimates for these countries. This article discusses prevailing international practices in using modelled estimates as a substitute for empirical data, and the implications of these practices for health policy. In conclusion, a strategic approach to strengthen national mortality statistics programmes in data deficient countries is presented, to improve NCD mortality measurement in the Asia-Pacific Region.
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Affiliation(s)
- Chalapati Rao
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Matthew Kelly
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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Rao C, Gupta M. The civil registration system is a potentially viable data source for reliable subnational mortality measurement in India. BMJ Glob Health 2021; 5:bmjgh-2020-002586. [PMID: 32792407 PMCID: PMC7430426 DOI: 10.1136/bmjgh-2020-002586] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/22/2020] [Accepted: 06/04/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction The Indian national Civil Registration System (CRS) is the optimal data source for subnational mortality measurement, but is yet under development. As an alternative, data from the Sample Registration System (SRS), which covers less than 1% of the national population, is used. This article presents a comparison of mortality measures from the SRS and CRS in 2017, and explores the potential of the CRS to meet these subnational data needs. Methods Data on population and deaths by age and sex for 2017 from each source were used to compute national-level and state-level life tables. Sex-specific ratios of death probabilities in five age categories (0–4, 5–14, 15–29, 30–69, 70–84) were used to evaluate CRS data completeness using SRS probabilities as reference values. The quality of medically certified causes of death was assessed through hospital reporting coverage and proportions of deaths registered with ill-defined causes from each state. Results The CRS operates through an extensive infrastructure with high reporting coverage, but child deaths are uniformly under-reported, as are female deaths in many states. However, at ages 30–69 years, CRS death probabilities are higher than the SRS values in 15 states for males and 10 states for females. SRS death probabilities are of limited precision for measuring mortality trends and differentials. Data on medically certified causes of death are of limited use due to low hospital reporting coverage. Conclusions The Indian CRS is more reliable than the SRS for measuring adult mortality in several states. Targeted initiatives to improve the recording of child and female deaths, to strengthen the reporting and quality of medically certified causes of death, and to promote use of verbal autopsy methods can establish the CRS as a reliable source of subnational mortality statistics in the near future.
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Affiliation(s)
- Chalapati Rao
- Research School of Population Health, Australian National University College of Medicine Biology and Environment, Canberra, Australian Capital Territory, Australia
| | - Mamta Gupta
- Alchemist Research and Data Analysis, Chandigarh, India
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Kelly M, Mathenge G, Rao C. Lessons Learnt and Pathways forward for National Civil Registration and Vital Statistics Systems after the COVID-19 Pandemic. J Epidemiol Glob Health 2021; 11:262-265. [PMID: 34270182 PMCID: PMC8435876 DOI: 10.2991/jegh.k.210531.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/02/2021] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has had a substantial impact on government services in many areas, including Civil Registration and Vital Statistics (CRVS). However, the pandemic has also highlighted the importance of recording of mortality and causes of death, with some potentially positive impacts for longer term CRVS strengthening, including: (1) increasing online provision of registration services (2) reporting of mortality statistics from settings which had not previously done so (3) improved intersectoral cooperation, particularly with the health sector, improving the ability to record deaths and (4) increased awareness among governments and public of the importance of mortality statistics. Now, it is pressing for national governments, and international organizations working to strengthen CRVS systems, to evaluate the effectiveness of strategies adopted over the last year, and use lessons learnt to catalyse broader sustainable CRVS improvement strategies, providing governments with essential data on mortality and causes of death into the future.
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Affiliation(s)
- Matthew Kelly
- Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, 62 Mills Road, Canberra, ACT 2600, Australia
| | - Gloria Mathenge
- Statistics for Development Division, Pacific Community (SPC), Noumea, New Caledonia
| | - Chalapati Rao
- Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, 62 Mills Road, Canberra, ACT 2600, Australia
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Fang Y, Pan H, Shou J, Hong W, Yang X, Zhu D, Zhou Y, Lan F, Rao C, Chen J. P86.22 Anlotinib plus Docetaxel versus Docetaxel as 2nd Line Treatment in Advanced Non-Small Cell Lung Cancer: A Phase I/II Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kumar R, Gupta M, M. Lakshmi PV, Prinja S, Singh T, Sirari T, Rao C. Comparative performance of verbal autopsy methods in identifying causes of adult mortality: A case study in India. Indian J Med Res 2021; 154:631-640. [PMID: 35435349 PMCID: PMC9205010 DOI: 10.4103/ijmr.ijmr_14_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background & objectives: Cause of death assignment from verbal autopsy (VA) questionnaires is conventionally accomplished through physician review. However, since recently, computer softwares have been developed to assign the cause of death. The present study evaluated the performance of computer software in assigning the cause of death from the VA, as compared to physician review. Methods: VA of 600 adult deaths was conducted using open- and close-ended questionnaires in Nandpur Kalour Block of Punjab, India. Entire VA forms were used by two physicians independently to assign the cause of death using the International Statistical Classification of Diseases and Related Health Problems (ICD)-10 codes. In case of disagreement between them, reconciliation was done, and in cases of persistent disagreements finally, adjudication was done by a third physician. InterVA-4-generated causes from close-ended questionnaires were compared using Kappa statistics with causes assigned by physicians using a questionnaire having both open- and close-ended questions. At the population level, Cause-Specific Mortality Fraction (CSMF) accuracy and P-value from McNemar’s paired Chi-square were calculated. CSMF accuracy indicates the absolute deviation of a set of proportions of causes of death out of the total number of deaths between the two methods. Results: The overall agreement between InterVA-4 and physician coding was ‘fair’ (κ=0.42; 95% confidence interval 0.38, 0.46). CSMF accuracy was found to be 0.71. The differences in proportions from the two methods were statistically different as per McNemar’s paired Chi-square test for ischaemic heart diseases, liver cirrhosis and maternal deaths. Interpretation & conclusions: In comparison to physicians, assignment of causes of death by InterVA- 4 was only ‘fair’. Hence, it may be appropriate to continue with physician review as the optimal option available in the current scenario.
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Sun Myint A, Dhadda A, Rao C, Sripadam R, Gerard JP. Will GRECCAR 2 be a game changer for the management of rectal cancer? Colorectal Dis 2020; 22:2330. [PMID: 32777139 DOI: 10.1111/codi.15304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 02/08/2023]
Affiliation(s)
- A Sun Myint
- Clatterbridge Cancer Centre, Liverpool, UK.,Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,Papillon Suite, Clatterbridge Cancer Centre, Wirral, UK
| | - A Dhadda
- Queen's Centre for Oncology and Haematology, Hull, UK
| | - C Rao
- Imperial College, University Hospital, London, UK
| | - R Sripadam
- Clatterbridge Cancer Centre, Liverpool, UK
| | - J P Gerard
- Service de Radiothérapie, Centre Antoine-Lacassagne, Nice, France
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Affiliation(s)
- Chalapati Rao
- Research School of Population Health, Australian National University, 62, Mills Road, Acton, Australian Capital Territory 2601, Australia
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Rao C, Usman Y, Kelly M, Angkasawati T, Kosen S. Building Capacity for Mortality Statistics Programs: Perspectives from the Indonesian Experience. J Epidemiol Glob Health 2020; 9:98-102. [PMID: 31241866 PMCID: PMC7310751 DOI: 10.2991/jegh.k.190429.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 04/21/2019] [Indexed: 11/01/2022] Open
Abstract
Information on deaths by age, sex, and cause are primary inputs for health policy and epidemiological research. Currently, most developing countries lack efficient death registration systems that generate these data on a routine and timely basis. The global community is promoting initiatives to establish and strengthen national mortality statistics programs across the developing world. Building human, technical, and institutional capacity to operate these programs are essential elements for the program. In Indonesia, the government has established a national Sample Registration System (SRS) covering a population of 9 million and is looking toward further scaling up of operations of the mortality statistics program in conjunction with expansion of the national Civil Registration and Vital Statistics (CRVS) systems. This article reports the theoretical and practical perspectives gained from experiences in developing human capacity in the Indonesian context. These perspectives are described in terms of the institutional, personnel, and functional components of the program for collection, compilation, analysis, and utilisation of mortality and cause of death data. The article also describes the challenges and potential solutions for implementing capacity building activities at national and subnational level. In conclusion, the need for and availability of training resources are discussed, including the potential for involvement of public health academia and international collaborations within a research framework on program management, quality evaluation, and data utilisation. Adequate attention to capacity building is essential to ensure the success and sustainability of national mortality statistics programs.
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Affiliation(s)
- Chalapati Rao
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
| | - Yuslely Usman
- Centre for Humanities and Health Management, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | - Matthew Kelly
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
| | - Trijuni Angkasawati
- Centre for Humanities and Health Management, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | - Soewarta Kosen
- Centre for Humanities and Health Management, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
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Zhang W, Usman Y, Iriawan RW, Lusiana M, Sha S, Kelly M, Rao C. Evaluating the quality of evidence for diagnosing ischemic heart disease from verbal autopsy in Indonesia. World J Cardiol 2019; 11:244-255. [PMID: 31754412 PMCID: PMC6859301 DOI: 10.4330/wjc.v11.i10.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/03/2019] [Accepted: 09/16/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mortality and cause of death data are fundamental to health policy development. Civil Registration and Vital Statistics systems are the ideal data source, but the system is still under development in Indonesia. A national Sample Registration System (SRS) has provided nationally representative mortality data from 128 sub-districts since 2014. Verbal autopsy (VA) is used in the SRS to obtain causes of death. The quality of VA data must be evaluated as part of the SRS data quality assessment.
AIM To assess the strength of evidence used in the assignment of Ischaemic Heart Disease (IHD) as causes of death from VA.
METHODS The sample frame for this study is the 4,070 deaths that had IHD assigned as the underlying cause in the SRS 2016 database. From these, 400 cases were randomly selected. A data extraction form and data entry template were designed to collect relevant data about IHD from VA questionnaires. A standardised categorisation was designed to assess the strength of evidence used to infer IHD as a cause of death. A pilot test of 50 cases was carried out. IBM SPSS software was used in this study.
RESULTS Strong evidence of IHD as a cause of death was assigned based on surgery for coronary heart disease, chest pain and two out of: sudden death, history of heart disease, medical diagnosis of heart disease, or terminal shortness of breath. More than half (53%) of the questionnaires contained strong evidence. For deaths outside health facilities, VA questionnaires for male deaths contained acceptable evidence in significantly higher proportions as compared to those for female deaths. (P < 0.001). Nearly half of all IHD deaths were concentrated in the 50-69 year age group (48.40%), and a further 36.10% were aged 70 years or more. Nearly two-thirds of the deceased were male (58.40%). Smoking behaviour was found in 44.11% of IHD deaths, but this figure was 73.82% among males.
CONCLUSION More than half of the VA questionnaires from the study sample were found to contain strong evidence to infer IHD as the cause of death. Results from medical records such as electrocardiograms, coronary angiographies, and load tests could have improved the strength of evidence and contributed to IHD cause of death diagnosis.
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Affiliation(s)
- Wenrong Zhang
- Department of Global Heath, Research School of Population Health, Australian National University, Canberra, ACT 2602, Australia
| | - Yuslely Usman
- National Agency for Health Research and Development, Ministry of Health, Jakarta 10110, Indonesia
| | - Retno Widyastuti Iriawan
- National Agency for Health Research and Development, Ministry of Health, Jakarta 10110, Indonesia
| | - Merry Lusiana
- National Agency for Health Research and Development, Ministry of Health, Jakarta 10110, Indonesia
| | - Sha Sha
- Department of Global Heath, Research School of Population Health, Australian National University, Canberra, ACT 2602, Australia
| | - Matthew Kelly
- Department of Global Heath, Research School of Population Health, Australian National University, Canberra, ACT 2602, Australia
| | - Chalapati Rao
- Department of Global Heath, Research School of Population Health, Australian National University, Canberra, ACT 2602, Australia
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Rao C. Elements of a strategic approach for strengthening national mortality statistics programmes. BMJ Glob Health 2019; 4:e001810. [PMID: 31681480 PMCID: PMC6797430 DOI: 10.1136/bmjgh-2019-001810] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/03/2019] [Accepted: 09/21/2019] [Indexed: 01/10/2023] Open
Abstract
Information on cause-specific mortality from civil registration and vital statistics (CRVS) systems is essential for health policy and epidemiological research. Currently, there are critical gaps in the international availability of timely and reliable mortality data, which limits planned progress towards the UN Sustainable Development Goals. This article describes an evidence-based strategic approach for strengthening mortality data from CRVS systems. National mortality data availability scores from the Global Burden of Disease study were used to group countries into those with adequate, partial or negligible mortality data. These were further categorised by geographical region and population size, which showed that there were shortcomings in availability of mortality data in approximately two-thirds of all countries. Existing frameworks for evaluating design and functional status of mortality components of CRVS systems were reviewed to identify themes and topics for assessment. Detailed national programme assessments can be used to investigate systemic issues that are likely to affect death reporting, cause of death ascertainment and data management. Assessment findings can guide interventions to strengthen system performance. The strategic national approach should be customised according to data availability and population size and supported by human and institutional capacity building. Countries with larger populations should use an incremental sampling approach to strengthen CRVS systems and use interim data for mortality estimation. Periodic data quality evaluation is required to monitor system performance and scale up interventions. A comprehensive implementation and operations research programme should be concurrently launched to evaluate the feasibility, success and sustainability of system strengthening activities.
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Affiliation(s)
- Chalapati Rao
- Department of Global Health, Research School of Population Health, Australian National University College of Medicine Biology and Environment, Canberra, Australian Capital Territory, Australia
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Morrell S, Taylor R, Nand D, Rao C. Changes in proportional mortality from diabetes and circulatory disease in Mauritius and Fiji: possible effects of coding and certification. BMC Public Health 2019; 19:481. [PMID: 31046741 PMCID: PMC6498492 DOI: 10.1186/s12889-019-6748-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/04/2019] [Indexed: 01/18/2023] Open
Abstract
Background Many developing countries are experiencing the epidemiological transition, with the majority of deaths attributed to cardiovascular disease, cancer, Type 2 diabetes (T2DM) and others. In some countries, large proportional mortality attributed to diabetes is evident in official mortality statistics, with Mauritius and Fiji rated as the highest in the world. Methods This study investigates trends in recorded diabetes and cardiovascular disease mortality in Mauritius and Fiji under coding from the International Classification of Diseases (ICD) versions 9 and 10, using mortality data reported from these countries to the World Health Organization (WHO). Results In Mauritius over 1981–2004, T2DM proportional mortality varied between 4% and 7% in males (M) and 5% and 9% in females (F). In 2005 there was a sudden increase to M 20% and F 25%, which continued to M 25% and F 30% by 2012. Over 1981–2004 the proportion of circulatory disease mortality rose from 44% to 49% in males, and from 46% to 57% in females. In 2005, circulatory disease mortality proportions fell precipitously to 34% in males and 37% in females, and declined to 31% and 34% by 2013. ICD–10 coding was introduced in 2005. In Fiji, sharp rises in proportional T2DM mortality from 3% in both sexes in 2001 to M 15% and F 20% in 2002 were followed by more gradual trend increases to M 20% and F 26% by 2012–13. Circulatory disease proportions fell steeply from M 57% and F 53% in 2001 to M 44% and M 38% by 2004, with subsequent less steep declines to M 39% and F 30% by 2012. ICD–10 coding was introduced in 2001. Conclusions Large, abrupt changes in diabetes and circulatory disease proportional mortality in Fiji and Mauritius coincided with the local introduction of ICD–10 coding in different years. There is also evidence for diabetes-related misclassification of underlying cause of death in Australia and the USA. These artefacts can undermine accurate monitoring of cause of death for evaluation of effectiveness of prevention and control, especially of circulatory disease mortality which is demonstrably reversible in populations.
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Affiliation(s)
- Stephen Morrell
- School of Public Health and Community Medicine (SPHCM), Faculty of Medicine University of New South Wales (UNSW), Sydney, Australia.
| | - Richard Taylor
- School of Public Health and Community Medicine (SPHCM), Faculty of Medicine University of New South Wales (UNSW), Sydney, Australia
| | | | - Chalapati Rao
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
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Lamba H, Kim M, Hart L, Chou B, Rao C, Chatterjee S, Sattee S, Cheema F, Civitello A, Delgado R, Nair A, Shafii A, Loor G, Rosengart T, Frazier O, Morgan J. Different Risk Factors for Ischemic and Hemorrhagic Stroke on Continuous Flow Left Ventricular Assist Device Support. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Kelly MJ, Rao C, Seubsman SA, Sleigh AC. Death in Transitional Asia: 11-Year All-Cause Mortality in the Thai Cohort Study. Glob J Health Sci 2019. [DOI: 10.5539/gjhs.v11n4p1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE: Thailand is experiencing a substantial reduction in overall mortality, an ageing society and increasing prevalence of non-communicable diseases. There is an urgent need to understand locally important risk factors for this new disease burden and their distribution. We investigated risk factors for mortality in a large cohort of Thai adults and report on key trends.
PARTICIPANTS: A nationwide cohort of 87,151 Thai adults followed up since 2005 with their data records linked to the Thai civil registration system to monitor mortality up to the end of 2016.
METHODS: We used logistic regression models to measure associations between a large range of socio-demographic, health behaviour and health status variables and all-cause mortality.
RESULTS: 1402 cohort members died between 2005 and 2016. In fully-adjusted models higher income, female sex, and higher education had the strongest protective effects against mortality. Normal body weight also protected (AOR 0.71 [0.52-0.96] with Obese as reference). Heavy smoking (AOR 1.48 [1.29-1.70]), and regular alcohol consumption (AOR 1.37 [1.12-1.68]) were associated with the highest mortality. Experiencing injury in the year proceeding the baseline survey also associated with increased mortality, while urbanising since childhood had a protective effect.
CONCLUSION: This study adds to evidence regarding risks for all-cause mortality in Thailand. Results indicate the need for Thailand to maintain successful tobacco control programs and to address the effects of increased alcohol consumption. The protective effect of higher education is particularly important in Thailand given the growing proportion of the population who are finishing high school and moving to higher education.
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Omar A, Ganapathy SS, Anuar MFM, Khoo YY, Jeevananthan C, Maria Awaluddin S, Yn JLM, Rao C. Cause-specific mortality estimates for Malaysia in 2013: results from a national sample verification study using medical record review and verbal autopsy. BMC Public Health 2019; 19:110. [PMID: 30678685 PMCID: PMC6345029 DOI: 10.1186/s12889-018-6384-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/28/2018] [Indexed: 01/17/2023] Open
Abstract
Background Mortality indicators are essential for monitoring population health. Although Malaysia has a functional death registration system, the quality of information on causes of death still needs improvement, since approximately 30% of deaths are classified to poorly defined causes. This study was conducted to verify registered causes in a sample of deaths in 2013 and utilise the findings to estimate cause-specific mortality indicators for Malaysia in 2013. Methods This is a cross-sectional study involving a nationally representative sample of 14,497 deaths distributed across 19 districts. Registered causes of deaths were verified using standard medical record review protocols for hospital deaths, and locally adapted international standard verbal autopsy procedures for deaths outside hospitals. The findings were used to measure the validity and reliability of the registration data, as well as to establish plausible cause-specific mortality fractions for hospital and non-hospital deaths, which were subsequently used as the basis for estimating national cause-specific mortality indicators. Results The overall response rate for the study was 67%. Verified causes of 5041 hospital deaths and 3724 deaths outside hospitals were used to derive national mortality estimates for 2013 by age, sex and cause. The study was able to reclassify most of the ill-defined deaths to a specific cause. The leading causes of deaths for males were Ischaemic Heart Disease (15.4%), Cerebrovascular diseases (13.7%), Chronic Obstructive Pulmonary Disease (8.5%) and Road Traffic Accident (8.0%). Among females, the leading causes were Cerebrovascular diseases (18.3%), Ischaemic Heart Disease (12.7%), Lower Respiratory Infections (11.5%) and Diabetes Mellitus (7.2%). Conclusions Investigation of registered causes of death using verbal autopsy and medical record review yielded adequate information to enable estimation of cause-specific mortality indicators in Malaysia. Strengthening the national mortality statistics system must be made a priority as it is a core data source for policy and evaluation of the public health and healthcare sectors in Malaysia.
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Affiliation(s)
- Azahadi Omar
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia.
| | - Shubash Shander Ganapathy
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | | | - Yi Yi Khoo
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chandrika Jeevananthan
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - S Maria Awaluddin
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Jane Ling Miaw Yn
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Chalapati Rao
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
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Sun Myint A, Dhadda A, Rao C, Sripadam R, Whitmarsh K, Gerard JP. Re: Evaluating the incidence of pathological complete response in current international rectal cancer practice: the barriers to widespread safe deferral of surgery. Colorectal Dis 2019; 21:119-120. [PMID: 30427583 DOI: 10.1111/codi.14472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 11/07/2018] [Indexed: 02/08/2023]
Affiliation(s)
- A Sun Myint
- Clatterbridge Cancer Centre NHS Foundation Trust, Papillon Suite, Wirral, UK.,Translational Research Department, University of Liverpool, Liverpool, UK
| | - A Dhadda
- Radiation Oncology, Castle Hill Hospital, Hull, UK
| | - C Rao
- Division of Cell and Molecular Biology, Colorectal Surgery, Imperial College London, London, UK
| | - R Sripadam
- Clatterbridge Cancer Centre NHS Foundation Trust, Papillon Suite, Wirral, UK
| | - K Whitmarsh
- Clatterbridge Cancer Centre NHS Foundation Trust, Papillon Suite, Wirral, UK
| | - J P Gerard
- Radiotherapy, Centre Antoine-Lacassagne, Nice, France
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Usman Y, Iriawan RW, Rosita T, Lusiana M, Kosen S, Kelly M, Forsyth S, Rao C. Indonesia’s Sample Registration System in 2018: A Work in Progress. ACTA ACUST UNITED AC 2018. [DOI: 10.25133/jpssv27n1.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Ai X, Lin Y, Zhang J, Xie C, Liu A, Hu X, Zhao Q, Zang Y, Rao C, Hu X, Chang L, Li Q, Guan Y, Chen R, Yi X, Lu S. MA16.06 EGFR Clonality and Tumor Mutation Burden (TMB) by Circulating Tumor DNA (ctDNA) Sequencing in Advanced Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rao C, Stewart A, Martin AP, Collins B, Pritchard DM, Athanasiou T, Sun Myint A. Contact X-ray Brachytherapy as an Adjunct to a Watch and Wait Approach is an Affordable Alternative to Standard Surgical Management of Rectal Cancer for Patients with a Partial Clinical Response to Chemoradiotherapy. Clin Oncol (R Coll Radiol) 2018; 30:625-633. [PMID: 30196845 DOI: 10.1016/j.clon.2018.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 05/25/2018] [Accepted: 06/10/2018] [Indexed: 11/28/2022]
Abstract
AIMS Emerging evidence suggests that contact X-ray brachytherapy (CXB) may increase the clinical complete response rate and durability when administered after standard chemoradiotherapy in patients with rectal cancer. The addition of CXB in partial responders is therefore probably cost-effective. The affordability of widening access to CXB in the UK, however, has not been evaluated. MATERIALS AND METHODS Decision analytical modelling with Monte Carlo simulation was used to evaluate long-term costs for the management of patients with rectal cancers who were given a CXB boost when a clinical complete response was not initially achieved following chemoradiotherapy in order to facilitate a watch and wait approach. A third-party payer (National Health Service) perspective was adopted, probabilistic sensitivity analysis was carried out and a scenario analysis was performed to investigate the effect of the number of referral centres and number of patients treated with CXB. RESULTS We estimate that 818 (95% confidence interval 628-1021) patients per year are eligible for CXB as an adjunct to a watch and wait approach in England and Wales. As this management is less costly than surgical management for each individual patient, the more patients treated, the more affordable the technology. Even if as few as 125 patients are treated nationally in 15 centres, the cost of implementing this technology would be less than £4 million. If the average number of patients treated in each centre is 30, this technology would be cost saving within 5 years. CONCLUSIONS The cost of CXB is not prohibitive according to the National Institute for Health and Care Excellence threshold for implementation of new technology and may even be cost saving within 5 years compared with standard surgical management, depending on the uptake of the technology and the number of referral centres.
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Affiliation(s)
- C Rao
- Queen Elizabeth Hospital, London, UK; Department of Surgery and Cancer, Imperial College London, UK.
| | - A Stewart
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | | | - B Collins
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - D M Pritchard
- Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, UK
| | - T Athanasiou
- Department of Surgery and Cancer, Imperial College London, UK
| | - A Sun Myint
- Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, UK; The Clatterbridge Cancer Centre, Bebington, UK
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Ozdemir R, Horasan GD, Rao C, Sozmen MK, Unal B. Re: Letter to the Editor of public health in response to 'An evaluation of cause-of-death trends from recent decades based on registered deaths in Turkey. Public Health 2018; 163:153-154. [PMID: 30149895 DOI: 10.1016/j.puhe.2018.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Affiliation(s)
- R Ozdemir
- Karabuk University, The Faculty of Health Sciences, Occupational Health and Safety Department, Karabuk, Turkey.
| | - G D Horasan
- Izmir University of Economics Faculty of Medicine, Department of Public Health, İzmir, Turkey.
| | - C Rao
- National Centre for Epidemiology & Population Health Research, School of Population Health, Australian National University, Canberra, Australia.
| | - M K Sozmen
- Izmir Katip Çelebi University Medical Faculty, Department of Public Health, İzmir, Turkey.
| | - B Unal
- Dokuz Eylul University Medical Faculty, Department of Public Health, İzmir, Turkey.
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Gu D, Rao C, Zheng Z. P3604Effect of preoperative low-molecular-weight heparin on major adverse cardiac events after coronary artery bypass grafting. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Gu
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China People's Republic of
| | - C Rao
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China People's Republic of
| | - Z Zheng
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China People's Republic of
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Lin S, Zheng Z, Zhang H, Rao C, Yan H, Wu Y, Tang Y, Dou K, Guan C, Sun Z, Xu L, Xia R, Xu B. P1647Real-time SYNTAX score feedback during coronary angiography to improve appropriateness of coronary revascularization for patients with stable coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Lin
- Fu Wai Hospital, Beijing, China People's Republic of
| | - Z Zheng
- Fu Wai Hospital, Beijing, China People's Republic of
| | - H Zhang
- Fu Wai Hospital, Beijing, China People's Republic of
| | - C Rao
- Fu Wai Hospital, Beijing, China People's Republic of
| | - H Yan
- Fu Wai Hospital, Beijing, China People's Republic of
| | - Y Wu
- Fu Wai Hospital, Beijing, China People's Republic of
| | - Y Tang
- Fu Wai Hospital, Beijing, China People's Republic of
| | - K Dou
- Fu Wai Hospital, Beijing, China People's Republic of
| | - C Guan
- Fu Wai Hospital, Beijing, China People's Republic of
| | - Z Sun
- Fu Wai Hospital, Beijing, China People's Republic of
| | - L Xu
- Fu Wai Hospital, Beijing, China People's Republic of
| | - R Xia
- Fu Wai Hospital, Beijing, China People's Republic of
| | - B Xu
- Fu Wai Hospital, Beijing, China People's Republic of
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Azmi L, Shukla I, Kant P, Rao C. 1-hydroxy-5, 7-dimethoxy-2 naphthalene-carboxaldehyde inhibitors as novel antimycobacterial agents targeting H-InMyoFib cells and targeting enzymes involved in fatty acid biosynthesis of bacilli. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Du J, Rao C, Zheng Z. P1701Randomized cluster trial to improve guideline-adherence of secondary preventive drugs prescription after coronary artery bypass grafting in China. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Du
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Cardiovascular Surgery, Beijing, China People's Republic of
| | - C Rao
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Cardiovascular Surgery, Beijing, China People's Republic of
| | - Z Zheng
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Cardiovascular Surgery, Beijing, China People's Republic of
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Sharma A, Rege S, Rao C. Mealtime behaviors in typically developing children and children with autism spectrum disorder (ASD). Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tran HT, Nguyen HP, Walker SM, Hill PS, Rao C. Validation of verbal autopsy methods using hospital medical records: a case study in Vietnam. BMC Med Res Methodol 2018; 18:43. [PMID: 29776431 PMCID: PMC5960129 DOI: 10.1186/s12874-018-0497-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 04/30/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Information on causes of death (COD) is crucial for measuring the health outcomes of populations and progress towards the Sustainable Development Goals. In many countries such as Vietnam where the civil registration and vital statistics (CRVS) system is dysfunctional, information on vital events will continue to rely on verbal autopsy (VA) methods. This study assesses the validity of VA methods used in Vietnam, and provides recommendations on methods for implementing VA validation studies in Vietnam. METHODS This validation study was conducted on a sample of 670 deaths from a recent VA study in Quang Ninh province. The study covered 116 cases from this sample, which met three inclusion criteria: a) the death occurred within 30 days of discharge after last hospitalisation, and b) medical records (MRs) for the deceased were available from respective hospitals, and c) the medical record mentioned that the patient was terminally ill at discharge. For each death, the underlying cause of death (UCOD) identified from MRs was compared to the UCOD from VA. The validity of VA diagnoses for major causes of death was measured using sensitivity, specificity and positive predictive value (PPV). RESULTS The sensitivity of VA was at least 75% in identifying some leading CODs such as stroke, road traffic accidents and several site-specific cancers. However, sensitivity was less than 50% for other important causes including ischemic heart disease, chronic obstructive pulmonary diseases, and diabetes. Overall, there was 57% agreement between UCOD from VA and MR, which increased to 76% when multiple causes from VA were compared to UCOD from MR. CONCLUSIONS Our findings suggest that VA is a valid method to ascertain UCOD in contexts such as Vietnam. Furthermore, within cultural contexts in which patients prefer to die at home instead of a healthcare facility, using the available MRs as the gold standard may be meaningful to the extent that recall bias from the interval between last hospital discharge and death can be minimized. Therefore, future studies should evaluate validity of MRs as a gold standard for VA studies in contexts similar to the Vietnamese context.
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Affiliation(s)
- Hong Thi Tran
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam. .,School of Public Health, University of Queensland, Brisbane, Australia.
| | - Hoa Phuong Nguyen
- Family Medicine Department, Hanoi Medical University, Hanoi, Vietnam
| | - Sue M Walker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,National Centre for Health Information Research and Training, Queensland University of Technology, Brisbane, Australia
| | - Peter S Hill
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Chalapati Rao
- Department of Global Health, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
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Ai X, Lin Y, Liu A, Xie C, Hu X, Zhao Q, Zang Y, Rao C, Yi X, Lu S. 52PD EGFR clonality and tumor mutation burden (TMB) analysis based on circulating tumor DNA (ctDNA) sequencing in advanced non-small cell lung cancer (NSCLC). J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30329-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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