Uncertainty and the reporting of intellectual disability on death certificates: a cross-sectional study of US mortality data from 2005 to 2017.
Uncertainty and the reporting of intellectual disability on death certificates: a cross-sectional study of US mortality data from 2005 to 2017.
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DOI：
10.1136/bmjopen-2020-045360
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发表时间：
2021-01-31
期刊：
影响因子：
2.9
通讯作者：
Bisesti E
中科院分区：
文献类型：
--
作者：
Landes SD;Turk MA;Bisesti E
调查围绕死亡的不确定性是否与智力残疾作为死亡根本原因的不准确报告相关。国家生命统计系统2005-2017年美国多种死因死亡率文件。USA.有智力残疾的成年人在死亡证明上报告，死亡时年满18岁。研究人群包括2005年1月1日至2017年12月31日期间在居住州死亡的26555名成年人。使用《疾病和有关健康问题国际统计分类》第十次修订版的智力残疾代码（F70-79）确定死亡证明上报告的智力残疾死者。双变量分析和多层次逻辑回归模型被用来调查是否个人层面和国家层面的特点，表明增加的不确定性，在死亡时与不准确的报告，智力残疾的根本原因死亡。将智力残疾不准确地报告为死亡的根本原因与社会人口学特征、死亡背景特征和合并症相关，表明围绕死亡的不确定性增加。最令人震惊的是，对于有窒息事件的死者，智力残疾被报告为潜在死亡原因的几率增加（OR=14.7; 95% CI 12.9至16.6，p<0.001），这是一种与高度不确定性相关的外部死亡原因，报告在他们的死亡证明上。至关重要的是，医务人员不能让增加的不确定性导致智力残疾作为死亡的根本原因的不准确报告，因为这种做法掩盖了这一人口的死亡原因趋势。相反，即使在死亡的不确定性增加的情况下，证明人也应该努力准确地确定导致死亡的疾病或伤害，并在死亡证明的第二部分报告残疾。
To investigate whether uncertainty surrounding the death is associated with the inaccurate reporting of intellectual disability as the underlying cause of death. National Vital Statistics System 2005–2017 US Multiple Cause-of-Death Mortality files. USA. Adults with an intellectual disability reported on their death certificate, aged 18 and over at the time of death. The study population included 26 555 adults who died in their state of residence between 1 January 2005 and 31 December 2017. Decedents with intellectual disability reported on their death certificate were identified using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code for intellectual disability (F70–79). Bivariate analysis and multilevel logistic regression models were used to investigate whether individual-level and state-level characteristics indicative of increased uncertainty at the time of death were associated with the inaccurate reporting of intellectual disability as the underlying cause of death. Inaccurate reporting of intellectual disability as the underlying cause of death was associated with sociodemographic characteristics, death context characteristics and comorbidities indicative of an increased amount of uncertainty surrounding the death. Most striking were increased odds of having intellectual disability reported as the underlying cause of death for decedents who had a choking event (OR=14.7; 95% CI 12.9 to 16.6, p<0.001), an external cause of death associated with a high degree of uncertainty, reported on their death certificate. It is imperative that medical personnel not let increased uncertainty lead to the inaccurate reporting of intellectual disability as the underlying cause of death as this practice obscures cause of death trends for this population. Instead, even in instances when increased uncertainty surrounds the death, certifiers should strive to accurately identify the disease or injury causing death, and report the disability in Part II of the death certificate.
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DOI：
10.1111/jir.12790
发表时间：
2021-01
期刊：
Journal of intellectual disability research : JIDR
影响因子：
--
作者：
Landes SD;Stevens JD;Turk MA
通讯作者：
Turk MA
DOI：
10.1111/j.1365-2788.2012.01614.x
发表时间：
2013-12-01
影响因子：
3.6
作者：
Landes, S. D.;Peek, C. W.
通讯作者：
Peek, C. W.
影响因子：
12.7
作者：
Krahn, Gloria L.;Walker, Deborah Klein;Correa-De-Araujo, Rosaly
通讯作者：
Correa-De-Araujo, Rosaly
影响因子：
2.9
作者：
Landes, Scott D.;Stevens, James Dalton;Turk, Margaret A.
通讯作者：
Turk, Margaret A.
影响因子：
--
作者：
De Alba, Israel;Sweningson, Jamie M.
通讯作者：
Sweningson, Jamie M.