Investigation of ill-defined causes of death: assessment of a program's performance in a State from the Northeastern region of Brazil

França, Elisabeth Barboza; Cunha, Carolina Cândida da; Vasconcelos, Ana Maria Nogales; Escalante, Juan José Cortez; Abreu, Daisy Xavier de; Lima, Raquel Barbosa de; Neto, Otaliba Libânio de Morais

doi:10.1590/1415-790x201400010010eng

Cited by 23 publications

(26 citation statements)

References 11 publications

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“…Studies in Ethiopia, India and China indicate that the VA method facilitates the clarification of the underlying cause of death in approximately 80% of the investigated deaths 14,15 . Similar results were observed using the VA form adapted for Brazil 9,16 . Since 2009, IOCMD and VA forms have been routinely implemented as part of death surveillance activities in the country, especially in the North and Northeast regions 8 .…”

Section: Introductionsupporting

confidence: 85%

“…Another probable cause may have been the difficulty of the researcher in identifying whether a new underlying cause was defined or not, and even what this new cause would be since the IOCMD and VA forms do not contain a section for the selection of the underlying cause and definitive conclusion of the research. This difficulty was also observed in the study that evaluated the investigation of DIDCs in the state of Alagoas 16 . Therefore, it is necessary to include specific fields in the forms that allow the professional responsible for the SIM to identify whether the data of the investigation have already been registered in the SIM, since some death investigations, as well as deaths and their respective investigations, duly completed and that were not recorded in the SIM, were found.…”

Section: Discussionmentioning

confidence: 87%

“…Since the implementation of the IOCMD and VA recommended forms for the investigation of DIDCs and incorporation of these data into the SIM, only one study 16 of the Program's performance evaluation has been published to date. This study aimed to estimate the adherence of the municipalities of Bahia to the recommendation of the Ministry of Health to investigate DIDCs, evaluate the use of the forms recommended in the investigation of these deaths and the impact of investigations on the percentage reduction of DIDCs in the Mortality Information System.…”

Section: Introductionmentioning

confidence: 99%

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Avaliação da investigação de óbitos por causas mal definidas no estado da Bahia, Brasil, em 2010

Cunha

Vasconcelos

Souza

et al. 2019

Ciênc. saúde coletiva

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Resumo A investigação de óbitos por causas mal definidas (CMD) tem sido uma estratégia utilizada pelos serviços de saúde para redução do percentual destes óbitos. Este estudo teve como objetivo avaliar a adesão dos municípios na utilização de formulários preconizados na investigação de óbitos por CMD e o impacto destas investigações na redução percentual desses óbitos no Sistema de Informações sobre Mortalidade. Analisou-se a utilização dos formulários Investigação do Óbito com Causa Mal Definida (IOCMD) e autópsia verbal (AV), e o percentual de reclassificação da causa básica (CB) de morte após as investigações, em uma amostra probabilística de 27 municípios no Estado da Bahia e a capital Salvador, no ano de 2010. Dos 27 municípios da amostra, aproximadamente 50% investigaram os óbitos por CMD utilizando-se os formulários preconizados. Foram identificados 1092 óbitos por CMD, dos quais 53,1% foram investigados: em 40,5% dos casos utilizou-se apenas o formulário IOCMD, apenas o formulário AV em 15,3%, e ambos os formulários em 14,3% dos casos. A investigação dos óbitos por CMD possibilitou a redução do percentual desses óbitos de 16,5% para 9,9%, e mostrou-se mais efetiva quando realizada utilizando-se os formulários preconizados.

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Section: Introductionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Avaliação da investigação de óbitos por causas mal definidas no estado da Bahia, Brasil, em 2010

Cunha

Vasconcelos

Souza

et al. 2019

Ciênc. saúde coletiva

Self Cite

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“…This can be explained by the fact that the certi cation of a home death is more di cult than deaths occurring inside hospitals due to the di culty of de ning a diagnosis for reasons already mentioned. The majority of home deaths in Brazil had medical assistance before death [24]. This nding reinforces the importance of continuing the investigation of household deaths until a culture valorizing the importance of the correct DC information is establishing among physicians.…”

Section: Discussionmentioning

confidence: 56%

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016

França

Ishitani

Teixeira

et al. 2020

Preprint

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Background: Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods: We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three and four digit ICD-10 codes considered as GC were selected and classified into four categories, according to the GBD study proposal. GCs levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996-2005 and 2006-2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state‐level estimates. Results: Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1-2 GCs in 1996-2005, but both SDI and completeness had a non-expected significant direct association with levels 3-4. In 2006-2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996-2016, but GCs levels 3-4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion: Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country.

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“…(16) In recent decades, Brazil has been applying efforts to improve the quality of data in SIM, including investigation of GCs. (17)(18)(19)(20)(21) As a result of investigation by municipal health departments, GCs from injury deaths has now been halved to 13%. (16) It is important to note that 81% of injury GCs were issued by forensic institutes, indicating inadequacies in many of these services in writing a death certificate that can be understood by coders and therefore correctly coded;…”

Section: Introductionmentioning

confidence: 99%

Improving the quality of external cause of death data in Brazil: evaluation and validation of a new form to investigate garbage codes

Filho

Lima

Merchán-Hamann

et al. 2020

Preprint

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Background: Accurate cause of death (COD) data are essential for policy and planning. Garbage codes (GCs), such as external causes with no further specific information, are commonly used as an indicator of poor quality of COD information. The investigation of GC using an effective instrument is necessary to convert them into useful data for public health. Aim: This study was conducted to analyze the effectiveness of the new investigation of deaths from external causes (IDEC) form, proposed by Ministry of Health, Brazil, to improve the quality of COD. Methods: The study compared the performance of the IDEC form on 164 external GC deaths with a stratified matched sample of 2,283 external GC deaths that used the existing standard GC form. The percentage of GCs that were reclassified into valid causes was calculated. Analyses according to subgroup (age, type of external cause) and exploration of the reclassifications of deaths between different cause groups were conducted. Qualitative data on the feasibility of the form were recorded by form users. Results: Investigation using the new form reduced all external GCs by 93% (95% confidence interval [CI] -97%, -88%), while the existing form decreased GCs by 66% (95% CI -68%, -64%). The IDEC form was most effective for external-cause GCs not of undetermined intent. Deaths that remained GCs were mainly due to a lack of detailed information on the circumstances of death, primarily poisoning and unspecified vehicle accidents occurring in a residence or on a road without witnesses. The IDEC form was found to be satisfactorily feasible in general, with specific suggestions for further improvement determined. Conclusions: The new form was more effective than the current standard form in reducing GCs and improving the quality of external causes. Feedback from the fieldwork highlighted opportunities for further improvement of external cause data.

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Investigation of ill-defined causes of death: assessment of a program's performance in a State from the Northeastern region of Brazil

Abstract: Our findings provide evidence that the training of the epidemiological surveillance teams in the investigation and certification of causes of death could contribute to improve the quality of mortality data.

Cited by 23 publications

References 11 publications

Avaliação da investigação de óbitos por causas mal definidas no estado da Bahia, Brasil, em 2010

Avaliação da investigação de óbitos por causas mal definidas no estado da Bahia, Brasil, em 2010

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016

Improving the quality of external cause of death data in Brazil: evaluation and validation of a new form to investigate garbage codes

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