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Death Certificate

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1. The quality of medical death certification of cause of death in hospitals in rural Bangladesh: impact of introducing the International Form of Medical Certificate of Cause of Death. (PubMed)

The quality of medical death certification of cause of death in hospitals in rural Bangladesh: impact of introducing the International Form of Medical Certificate of Cause of Death. Accurate and timely data on cause of death are critically important for guiding health programs and policies. Deaths certified by doctors are implicitly considered to be reliable and accurate, yet the quality of information provided in the international Medical Certificate of Cause of Death (MCCD) usually varies (...) project physicians assigned an underlying cause of death, assessed the quality of the death certificate, and reported the degree of certainty of the medical records provided for a given cause. We examined the frequency of common errors in completing the MCCD, the leading causes of in-hospital deaths, and the degree of certainty in the cause of death data.The study included 4914 death certificates. 72.9% of medical records were of too poor quality to assign a cause of death, with little difference

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2017 BMC health services research

2. Place of death in a small island state: a death certificate population study. (PubMed)

Place of death in a small island state: a death certificate population study. Low/middle-income countries, particularly Small Island Developing States, face many challenges including providing good palliative care and choice in place of care and death, but evidence of the circumstances of dying to inform policy is often lacking. This study explores where people die in Trinidad and Tobago and examines and describes the factors associated with place of death.A population-level analysis (...) of routinely collected death certificate and supplementary health data where the unit of analysis was the recorded death. We followed the Reporting of Studies Conducted Using Observational Routinely Collected Health Data reporting guidelines, an extension of Strengthening the Reporting of Observational Studies in Epidemiology, on a deidentified data set on decedents (n=10 221) extracted from International Statistical Classification of Diseases version 10 coded death records for the most recent available

2019 BMJ Supportive & Palliative Care

3. Contemporary accuracy of death certificates for coding prostate cancer as a cause of death: Is reliance on death certification good enough? A comparison with blinded review by an independent cause of death evaluation committee. (PubMed)

Contemporary accuracy of death certificates for coding prostate cancer as a cause of death: Is reliance on death certification good enough? A comparison with blinded review by an independent cause of death evaluation committee. Accurate cause of death assignment is crucial for prostate cancer epidemiology and trials reporting prostate cancer-specific mortality outcomes.We compared death certificate information with independent cause of death evaluation by an expert committee within a prostate (...) cancer trial (2002-2015).Of 1236 deaths assessed, expert committee evaluation attributed 523 (42%) to prostate cancer, agreeing with death certificate cause of death in 1134 cases (92%, 95% CI: 90%, 93%). The sensitivity of death certificates in identifying prostate cancer deaths as classified by the committee was 91% (95% CI: 89%, 94%); specificity was 92% (95% CI: 90%, 94%). Sensitivity and specificity were lower where death occurred within 1 year of diagnosis, and where there was another primary

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2016 British Journal of Cancer Controlled trial quality: uncertain

4. Educational Case: Death Certification and the Role of the Medical Examiner/Coroner (PubMed)

Educational Case: Death Certification and the Role of the Medical Examiner/Coroner The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three

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2018 Academic pathology

5. Improving hospital death certification in Viet Nam: results of a pilot study implementing an adapted WHO hospital death report form in two national hospitals (PubMed)

Improving hospital death certification in Viet Nam: results of a pilot study implementing an adapted WHO hospital death report form in two national hospitals Viet Nam does not have a system for the national collection of death data that meets international requirements for mortality reporting. It is identified as a 'no-report' country by the WHO. Verbal autopsy reports are used in the community but exclude deaths in hospitals.This project was undertaken in Bach Mai National General Hospital (...) and Viet Duc Surgical and Trauma Hospital in Viet Nam from 1 March 2013 to 31 March 2015. In phase 1, a modified hospital death report form, consistent with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, was developed. Small group training in use of the report form was delivered to 427 doctors. In phase two, death data were collected, collated and analysed. In phase three, a random sample (7%) of all report forms was checked for accuracy

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2016 BMJ global health

6. Place of death for people with HIV: a population-level comparison of eleven countries across three continents using death certificate data. (PubMed)

Place of death for people with HIV: a population-level comparison of eleven countries across three continents using death certificate data. With over 1 million HIV-related deaths annually, quality end-of-life care remains a priority. Given strong public preference for home death, place of death is an important consideration for quality care. This 11 country study aimed to i) describe the number, proportion of all deaths, and demographics of HIV-related deaths; ii) identify place of death; iii (...) ) compare place of death to cancer patients iv), determine patient/health system factors associated with place of HIV-related death.In this retrospective analysis of death certification, data were extracted for the full population (ICD-10 codes B20-B24) for 1-year period: deceased's demographic characteristics, place of death, healthcare supply.i) 19,739 deaths were attributed to HIV. The highest proportion (per 1000 deaths) was for Mexico (9.8‰), and the lowest Sweden (0.2‰). The majority of deaths

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2018 BMC Infectious Diseases

7. Standard Death Certificates Versus Enhanced Surveillance to Identify Heroin Overdose-Related Deaths. (PubMed)

Standard Death Certificates Versus Enhanced Surveillance to Identify Heroin Overdose-Related Deaths. To compare 2 approaches to identifying heroin-related deaths in cases of overdose: standard death certificates and enhanced surveillance.We reviewed Maryland death certificates from 2012 to 2015 in cases of overdose to determine specific mentions of heroin. Counts were compared with estimates obtained through an enhanced surveillance approach that included a protocol considering cause of death (...) , toxicology, and scene investigation findings.Death certificates identified 1130 heroin-related deaths. Enhanced surveillance identified 2182 cases, nearly double the number found through the standard approach. The major factors supporting enhanced surveillance in identifying cases were the presence of morphine, either alone or in combination with quinine, and scene investigation information suggesting heroin use.Death certificates, the primary source of state and national data on overdose deaths, may

2018 American Journal of Public Health

8. Leading causes of death among decedents with mention of schizophrenia on the death certificates in the United States. (PubMed)

Leading causes of death among decedents with mention of schizophrenia on the death certificates in the United States. Little is known about the changes in the ranking of leading cause of death (COD) among people died with schizophrenia across years in the United States (U.S.). This study aims to determine the ranking of leading COD among U.S. decedents with mention of schizophrenia by age from 2000 to 2015.The mortality multiple COD files maintained by the National Center for Health Statistics (...) were used to identify decedents aged 15 years old and above with mention of schizophrenia anywhere on the death certificates to determine the number and proportion of deaths attributed to various underlying CODs.Of 13,289, 13,655, 14,135, and 15,033 people who died in 2000-2003, 2004-2007, 2008-2011and 2012-2015 with mention of schizophrenia, similar to all decedents, heart disease and cancer was the first and the second leading COD throughout the study years. Schizophrenia ranked the third in most

2018 Schizophrenia Research

9. Continuous Deep Sedation Until Death-a Swiss Death Certificate Study. (PubMed)

Continuous Deep Sedation Until Death-a Swiss Death Certificate Study. In the last decade, the number of patients continuously deeply sedated until death increased up to fourfold. The reasons for this increase remain unclear.To identify socio-demographic and clinical characteristics of sedated patients, and concurrent possibly life-shortening medical end-of-life decisions.Cross-sectional death certificate study in German-speaking Switzerland in 2001 and 2013.Non-sudden and expected deaths (2001 (...) : N = 2281, 2013: N = 2256) based on a random sample of death certificates and followed by an anonymous survey on end-of-life practices among attending physicians.Physicians' reported proportion of patients continuously deeply sedated until death, socio-demographic and clinical characteristics, and possibly life-shortening medical end-of life decisions.In 2013, physicians sedated four times more patients continuously until death (6.7% in 2001; 24.5.5% in 2013). Four out of five sedated patients

2018 Journal of General Internal Medicine

10. In-hospital dementia-related deaths following implementation of the national dementia plan: observational study of national death certificates from 1996 to 2016. (PubMed)

In-hospital dementia-related deaths following implementation of the national dementia plan: observational study of national death certificates from 1996 to 2016. To examine changes in places of dementia-related death following implementation of the national dementia plan and other policy initiatives.Observational study.Japan between October 1996 and September 2016. Four major changes in health and social care systems were identified: (1) the public long-term care insurance programme (April 2000 (...) ); (2) community centres as a first access point for older residents (April 2006); (3) medical care system for older people (April 2008) and (4) the national dementia plan (April 2013).9 60 423 decedents aged 65 years or older whose primary cause of death was Alzheimer's disease, vascular or other types of dementia or senility.Place of death which was classified into 'hospital', 'intermediate geriatric care facility' (rehabilitation facility aimed at home discharge), 'nursing home' or 'own home

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2018 BMJ open

11. Trends in premature mortality in the USA by sex, race, and ethnicity from 1999 to 2014: an analysis of death certificate data. (PubMed)

Trends in premature mortality in the USA by sex, race, and ethnicity from 1999 to 2014: an analysis of death certificate data. Reduction of premature mortality is a UN Sustainable Development Goal. Unlike other high-income countries, age-adjusted mortality in the USA plateaued in 2010 and increased slightly in 2015, possibly because of rising premature mortality. We aimed to analyse trends in mortality in the USA between 1999 and 2014 in people aged 25-64 years by age group, sex, and race (...) and ethnicity, and to identify specific causes of death underlying the temporal trends.For this analysis, we used cause-of-death and demographic data from death certificates from the US National Center for Health Statistics, and population estimates from the US Census Bureau. We estimated annual percentage changes in mortality using age-period-cohort models. Age-standardised excess deaths were estimated for 2000 to 2014 as observed deaths minus expected deaths (estimated from 1999 mortality rates).Between

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2017 Lancet

12. Identification of American Indians and Alaska Natives in Public Health Data Sets: A Comparison Using Linkage-Corrected Washington State Death Certificates. (PubMed)

Identification of American Indians and Alaska Natives in Public Health Data Sets: A Comparison Using Linkage-Corrected Washington State Death Certificates. Efforts to address disparities experienced by American Indians/Alaska Natives (AI/AN) have been hampered by a lack of accurate and timely health data. One challenge to obtaining accurate data is determining who "counts" as AI/AN in health and administrative data sets.To compare the effects of definition and misclassification of AI (...) /AN on estimates of all-cause and cause-specific mortality for AI/AN in Washington during 2015-2016.Secondary analysis of death certificate data from Washington State. Data were corrected for AI/AN racial misclassification through probabilistic linkage with the Northwest Tribal Registry. Counts and age-adjusted rates were calculated and compared for 6 definitions of AI/AN. Comparisons were made with the non-Hispanic white population to identify disparities.Washington State.AI/AN and non-Hispanic white

2019 Journal of Public Health Management and Practice

13. Trends in overall, cardiovascular and cancer-related mortality among individuals with diabetes reported on death certificates in the United States between 2007 and 2017. (PubMed)

Trends in overall, cardiovascular and cancer-related mortality among individuals with diabetes reported on death certificates in the United States between 2007 and 2017. The determination of diabetes as underlying cause of death by using the death certificate may result in inaccurate estimation of national mortality attributed to diabetes, because individuals who die with diabetes generally have other conditions that may contribute to their death. We investigated the trends in age-standardised (...) mortality due to diabetes as underlying or contributing cause of death and cause-specific mortality from cardiovascular disease (CVD), complications of diabetes and cancer among individuals with diabetes listed on death certificates in the USA from 2007 to 2017.Using the US Census and national mortality database, we calculated age-standardised mortality due to diabetes as underlying or contributing cause of death and cause-specific mortality rates among adults over 20 years with diabetes listed on death

2019 Diabetologia

14. Automatic classification of free-text medical causes from death certificates for reactive mortality surveillance in France. (PubMed)

Automatic classification of free-text medical causes from death certificates for reactive mortality surveillance in France. Mortality surveillance is of fundamental importance to public health surveillance. The real-time recording of death certificates, thanks to Electronic Death Registration System (EDRS), provides valuable data for reactive mortality surveillance based on medical causes of death in free-text format. Reactive mortality surveillance is based on the monitoring of mortality (...) syndromic groups (MSGs). An MSG is a cluster of medical causes of death (pathologies, syndromes or symptoms) that meets the objectives of early detection and impact assessment of public health events. The aim of this study is to implement and measure the performance of a rule-based method and two supervised models for automatic free-text cause of death classification from death certificates in order to implement them for routine surveillance.A rule-based method was implemented using four processing

2019 International journal of medical informatics

15. Risk factors for hospital death in conditions needing palliative care: Nationwide population-based death certificate study. (PubMed)

Risk factors for hospital death in conditions needing palliative care: Nationwide population-based death certificate study. Most people would prefer to die at home as opposed to hospital; therefore, understanding mortality patterns by place of death is essential for health resources allocation.We examined trends and risk factors for hospital death in conditions needing palliative care in a country without integrated palliative care.This is a death certificate study. We examined factors (...) associated with hospital death using logistic regression.All adults (1,045,381) who died between 2003 and 2012 in Portugal were included. We identified conditions needing palliative care from main causes of death: cancer, heart/cerebrovascular, renal, liver, respiratory and neurodegenerative diseases, dementia/Alzheimer's/senility and HIV/AIDS.Conditions needing palliative care were responsible for 70.7% deaths ( N = 738,566, median age 80); heart and cerebrovascular diseases (43.9%) and cancer (32.2

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2017 Palliative medicine

16. Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data (PubMed)

Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 (...) Cohen at Vrije University in Brussels and co-workers examined international death certificate data collected from 14 countries to determine place of death for patients with lung cancer and chronic obstructive pulmonary disease (COPD). While patients with COPD suffer similar symptoms to lung cancer in their final days, few COPD patients receive palliative care or achieve the common wish of dying at home. This may be partly due to the inherent unpredictability of final-stage COPD compared with lung

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2017 NPJ primary care respiratory medicine

17. Medical end-of-life practices in Swiss cultural regions: a death certificate study. (PubMed)

Medical end-of-life practices in Swiss cultural regions: a death certificate study. End-of-life decisions remain controversial. Switzerland, with three main languages shared with surrounding countries and legal suicide assistance, allows exploration of the effects of cultural differences on end-of-life practices within the same legal framework.We conducted a death certificate study on a nationwide continuous random sample of Swiss residents. Using an internationally standardized tool, we sent (...) 4998, 2965, and 1000 anonymous questionnaires to certifying physicians in the German-, French-, and Italian-speaking regions.The response rates were 63.5%, 51.9%, and 61.7% in the German-, French-, and Italian-speaking regions, respectively. Non-sudden, expected deaths were preceded by medical end-of-life decisions (MELDs) more frequently in the German- than in the French- or Italian-speaking region (82.3% vs. 75.0% and 74.0%, respectively), mainly due to forgoing life-prolonging treatment (70.0

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2018 BMC Medicine

18. Accuracy and the factors influencing the accuracy of death certificates completed by first-year general practitioners in Thailand. (PubMed)

Accuracy and the factors influencing the accuracy of death certificates completed by first-year general practitioners in Thailand. Although death certificates (DCs) provide valuable health information which may help to guide local health policies and priorities, there is little information concerning their validity in Thailand. First-year general practitioners (GPs) have a major role in DC completion, especially in provincial general hospitals. The aim of this study was to evaluate the accuracy (...) and factors influencing the accuracy of DCs completed by first-year GPs in Thailand, compared with the cause of death (COD) derived from medical records by experts.This retrospective study was conducted at 14 provincial general hospitals in Thailand during the June 2011 to May 2012 study period. Medical records and DCs completed by first-year GPs who graduated from 16 Thai medical schools were sampled. The cause of death recorded on the DCs was compared with the medical conditions and histories derived

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2018 BMC health services research

19. National Association of Medical Examiners position paper: Recommendations for the investigation and certification of deaths in people with epilepsy. (PubMed)

National Association of Medical Examiners position paper: Recommendations for the investigation and certification of deaths in people with epilepsy. Sudden unexpected death of an individual with epilepsy can pose a challenge to death investigators, as most deaths are unwitnessed, and the individual is commonly found dead in bed. Anatomic findings (eg, tongue/lip bite) are commonly absent and of varying specificity, thereby limiting the evidence to implicate epilepsy as a cause of or contributor (...) to death. Thus it is likely that death certificates significantly underrepresent the true number of deaths in which epilepsy was a factor. To address this, members of the National Association of Medical Examiners, North American SUDEP Registry, Epilepsy Foundation SUDEP Institute, American Epilepsy Society, and the Centers for Disease Control and Prevention constituted an expert panel to generate evidence-based recommendations for the practice of death investigation and autopsy, toxicological analysis

2018 Epilepsia

20. Physicians' knowledge and practice on death certification in the North West Bank, Palestine: across sectional study. (PubMed)

Physicians' knowledge and practice on death certification in the North West Bank, Palestine: across sectional study. Mortality data are essential for many aspects of everyday public health practices at both national and international levels. Despite the current developments in various aspects of the medical field, the apparent inability of physicians to complete death notification forms (DNF) accurately is still worldwide concern. The aim of this study is to assess the physicians' knowledge (...) the accuracy of mortality data. Complicated cases, problems in the current design of the DNFs and lack of training were the most common factors contributing to inaccuracy in death certification. We recommend offering periodical training workshops on completing the DNF to all physicians, and developing a manual on completing the DNFs with clear instructions and guidelines.

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2018 BMC health services research

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