Quality of cause-of-death statements and its impact on infant mortality statistics in Hermosillo, Mexico

Álvarez, Gerardo; Harlow, Sioḃán D.; Denman, Catalina A.; Hofmeister, Mary J.

doi:10.1590/s1020-49892009000200004

Cited by 8 publications

(7 citation statements)

References 22 publications

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“…Agreement at the 2-digit classification level dropped to 50%, a proportion similar to that reported for infant deaths in Hermosillo. 20 In contrast, a study of adults in Brazil found a higher rate of overall agreement (83%; kappa=0.76) at the 3-digit ICD-10 level. However, 30% of the original statements of death were based on autopsy results, which likely increased the accuracy of the original COD.…”

Section: Discussionmentioning

confidence: 90%

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Validity of underlying cause of death statistics in Hermosillo, Mexico

et al. 2011

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Objective. This paper assesses the quality of the underlying cause of death (COD) statistics in Hermosillo, Mexico in a random sample of 300 in-hospital adult deaths. Material and Methods. A "gold standard" COD, determined by a systematic review of hospital medical charts, was compared to the COD reported by the vital registry system. Results. Overall agreement between the reviewer and original COD at the ICD-10 chapter block was 69.2%, with a weighted kappa of 0.62. Agreement varied greatly by ICD-10 chapter. Mutual misclassification among common co-morbidities, such as diabetes mellitus and circulatory disease, minimized the net change in the mortality fraction assigned to each ICD-10 chapter after physician review. Conclusions. The ICD-10 chapter level underlying COD codes can be used to estimate disease burden in the population. Caution is recommended for use of vital registry statistics in Hermosillo for individual level or disease-specific analyses.

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Section: Discussionmentioning

confidence: 90%

“…In 2003, Alvarez et al investigated the quality of underlying cause of death data coded in the vital registry for a sample of infant deaths. 20 That study indicated a need to improve coding to ensure accurate interpretation of infant mortality patterns.…”

Section: Introductionmentioning

confidence: 99%

Validity of underlying cause of death statistics in Hermosillo, Mexico

et al. 2011

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“…Studies in various countries [7-13], including Mexico [14,15], have assessed the validity of death certification by comparing the underlying cause of death in the medical death certificate with other sources that provide additional information regarding cause of death, such as medical records. In general, these studies indicate that the concordance between causes of death from death certificates and those obtained using other sources vary by place and cause of death.…”

Section: Introductionmentioning

confidence: 99%

“…The information from Latin America comes mainly from studies in Brazil, analyzing the validity and reliability of cause of death registration in specific areas of the country [9,10]. In Mexico, these studies have concentrated on infant deaths [14,15]. To our knowledge, there is no single study in Mexico that has analyzed the reliability of causes of death based on death certificates for a wide range of diseases.…”

Section: Introductionmentioning

confidence: 99%

Assessing quality of medical death certification: Concordance between gold standard diagnosis and underlying cause of death in selected Mexican hospitals

Hernández

Ramírez-Villalobos

Romero

et al. 2011

Popul Health Metrics

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BackgroundIn Mexico, the vital registration system relies on information collected from death certificates to generate official mortality figures. Although the death certificate has high coverage across the country, there is little information regarding its validity. The objective of this study was to assess the concordance between the underlying cause of death in official statistics obtained from death certificates and a gold standard diagnosis of the same deaths derived from medical records of hospitals.MethodsThe study sample consisted of 1,589 deaths that occurred in 34 public hospitals in the Federal District and the state of Morelos, Mexico in 2009. Neonatal, child, and adult cases were selected for causes of death that included infectious diseases, noncommunicable diseases, and injuries. We compared the underlying cause of death, obtained from medical death certificates, against a gold standard diagnosis derived from a review of medical records developed by the Population Health Metrics Research Consortium. We used chance-corrected concordance and accuracy as metrics to evaluate the quality of performance of the death certificate.ResultsAnalysis considering only the underlying cause of death resulted in a median chance-corrected concordance between the cause of death in medical death certificates versus the gold standard of 54.3% (95% uncertainty interval [UI]: 52.2, 55.6) for neonates, 38.5% (37.0, 40.0) for children, and 66.5% (65.9, 66.9) for adults. The accuracy resulting from the same analysis was 0.756 (0.747, 0.769) for neonates, 0.683 (0.663, 0.701) for children, and 0.780 (0.774, 0.785) for adults. Median chance-corrected concordance and accuracy increased when considering the mention of any cause of death in the death certificate, not just the underlying cause. Concordance varied substantially depending on cause of death, and accuracy varied depending on the true cause-specific mortality fraction composition.ConclusionsAlthough we cannot generalize our conclusions to Mexico as a whole, the results demonstrate important problems with the quality of the main source of information for causes of death used by decision-makers in settings with highly technological vital registration systems. It is necessary to improve death certification procedures, especially in the case of child and neonatal deaths. This requires an important commitment from the health system and health institutions.

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“…This effect has been described in other countries. 27,28 However, this effect was not observed in all ecological units, which may be explained by the different degrees of structural modification of the records, over time.…”

Section: Discussionmentioning

confidence: 89%

Ecuadorian infant mortality linked to socioeconomic factors during the last 30 years

Romero-Sandoval

Alcázar

Pastor³

et al. 2019

Rev. Bras. Saude Mater. Infant.

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Objectives: to analyze the difference among geographical units and the evolution of infant mortality rate (IMR) based on Ecuadorian censuses (1990-2001-2010). Methods: artificial Neural Network analyzed the impact of sociodemographic factors over the variability of IMR. Poisson regression analyzed the variation of the standardized IMR (sIMR). Results: the decrease in the national IMR was 63.8%; however, 42.8% provinces showed an increase in 2001-2010. The variability was explained mainly by illiteracy decrease. The adjusted RR between provincial sIMR with illiteracy and poverty revealed a trend towards the unit. Conclusions: the variation of IMR reflects a complex interaction of the sociodemographic factors.

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Quality of cause-of-death statements and its impact on infant mortality statistics in Hermosillo, Mexico

Abstract: More than half (53%) of COD statements in infant death certificates in Hermosillo were inaccurately completed, which may lead to inaccurate interpretation of causes of infant mortality. Systematic assessments of the quality of COD statements may improve the quality of mortality statistics.

Cited by 8 publications

References 22 publications

Validity of underlying cause of death statistics in Hermosillo, Mexico

Validity of underlying cause of death statistics in Hermosillo, Mexico

Assessing quality of medical death certification: Concordance between gold standard diagnosis and underlying cause of death in selected Mexican hospitals

Ecuadorian infant mortality linked to socioeconomic factors during the last 30 years

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