Cause-of-death ascertainment for deaths that occur outside hospitals in Thailand: application of verbal autopsy methods.
Cause-of-death ascertainment for deaths that occur outside hospitals in Thailand: application of verbal autopsy methods.
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DOI：
10.1186/1478-7954-8-13
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发表时间：
2010-05-18
影响因子：
3.3
通讯作者：
Lopez AD
中科院分区：
文献类型：
--
作者：
Polprasert W;Rao C;Adair T;Pattaraarchachai J;Porapakkham Y;Lopez AD
在包括泰国在内的许多国家，确定在缺乏医疗照顾的情况下发生的死亡原因是一个重大问题，在泰国，超过50%的死亡登记原因不明。常规执行标准化、严格的死因推断方法是一个潜在的解决办法。本文报道了在泰国进行的实地研究的结果，以开发，测试和验证使用死因推断（VA）的方法。国际死因推断方法首先适用于泰国的情况，然后用于确定2005年在泰国发生的11 984例死亡的全国代表性样本的死因。死亡原因来自于接受过ICD死亡原因认证培训的医生完成的VA问卷。VA诊断在医院死亡的样本中进行了验证，其中参考诊断可从病历审查中获得。经验证的研究结果用于调整研究样本中发生在医院外的死亡的基于VA的死亡原因。结果被用来估计2005年泰国医院外死亡的原因特异性死亡率模式。在研究样本中，7，340例发生在医院外的死亡中有6，328例基于VA的死亡原因，构成了研究的验证组。VA的使用导致了大规模的死亡从定义不清的类别重新分配到特定的死亡原因。验证研究发现，VA倾向于过度诊断糖尿病，肝癌和肺结核等重要原因，而低估了艾滋病毒/艾滋病，肝脏疾病，泌尿生殖系统（基本肾脏）和消化系统疾病的死亡。使用标准的VA方法适应泰国，使一个合理的评估的原因特异性死亡率模式和大量减少不明确的诊断。验证研究提高了应用死因推断的调查结果的实用性。在泰国定期实施VA可以加快医院外死亡的重要登记数据的质量和实用性的发展。
Ascertainment of cause for deaths that occur in the absence of medical attention is a significant problem in many countries, including Thailand, where more than 50% of such deaths are registered with ill-defined causes. Routine implementation of standardized, rigorous verbal autopsy methods is a potential solution. This paper reports findings from field research conducted to develop, test, and validate the use of verbal autopsy (VA) methods in Thailand. International verbal autopsy methods were first adapted to the Thai context and then implemented to ascertain causes of death for a nationally representative sample of 11,984 deaths that occurred in Thailand in 2005. Causes of death were derived from completed VA questionnaires by physicians trained in ICD-based cause-of-death certification. VA diagnoses were validated in the sample of hospital deaths for which reference diagnoses were available from medical record review. Validated study findings were used to adjust VA-based causes of death derived for deaths in the study sample that had occurred outside hospitals. Results were used to estimate cause-specific mortality patterns for deaths outside hospitals in Thailand in 2005. VA-based causes of death were derived for 6,328 out of 7,340 deaths in the study sample that had occurred outside hospitals, constituting the verification arm of the study. The use of VA resulted in large-scale reassignment of deaths from ill-defined categories to specific causes of death. The validation study identified that VA tends to overdiagnose important causes such as diabetes, liver cancer, and tuberculosis, while undercounting deaths from HIV/AIDS, liver diseases, genitourinary (essential renal), and digestive system disorders. The use of standard VA methods adapted to Thailand enabled a plausible assessment of cause-specific mortality patterns and a substantial reduction of ill-defined diagnoses. Validation studies enhance the utility of findings from the application of verbal autopsy. Regular implementation of VA in Thailand could accelerate development of the quality and utility of vital registration data for deaths outside hospitals.
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影响因子：
7.7
作者：
Etard, JF;Le Hesran, JY;Delaunay, V
通讯作者：
Delaunay, V
DOI：
10.2471/blt.05.029124
发表时间：
2006-03-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Garenne, Michel;Fauveau, Vincent
通讯作者：
Fauveau, Vincent
影响因子：
3.3
作者：
Pattaraarchachai J;Rao C;Polprasert W;Porapakkham Y;Pao-In W;Singwerathum N;Lopez AD
通讯作者：
Lopez AD
影响因子：
3.3
作者：
Rao C;Porapakkham Y;Pattaraarchachai J;Polprasert W;Swampunyalert N;Lopez AD
通讯作者：
Lopez AD
影响因子：
7.7
作者：
Chandramohan, D;Setel, P;Quigley, M
通讯作者：
Quigley, M