National adaptations of the ICD rules for classification - A problem in the evaluation of cause-of-death trends
National adaptations of the ICD rules for classification - A problem in the evaluation of cause-of-death trends
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DOI：
10.1016/s0895-4356(96)00426-x
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发表时间：
1997-04-01
影响因子：
7.2
通讯作者：
Svanstrom, L
中科院分区：
文献类型：
--
作者：
Jansson, B;Johansson, LA;Svanstrom, L
1981年，瑞典死亡原因登记处的登记程序进行了调整。本研究的目的是评估1981年后这些登记实践的变化可能对死因趋势产生的影响。在整个研究期间（1976-1985年）使用了《国际疾病分类第八修订版》（ICD-8），在仔细检查的18个诊断组中，有13个组的登记病例数发生了重大变化。观察到四种主要类型的结果：（a）潜在原因的数量增加，而促成原因的数量减少，反之亦然;（B）由于诊断组从一个ICD类别转移到另一个ICD类别，潜在原因和促成原因的数量沿同一方向变化;（c）基本因由及分担因由的数目均向同一方向改变，但并非由于转移。一个诊断组;或（d）潜在或促成原因的数量发生变化，但不是两者都发生变化。一般来说，登记做法的改变导致更多的情况，这些情况往往被认为是其他疾病的晚期并发症，但却被登记为死亡的根本原因。虽然1981年的大多数说明意味着ICD-8的更多字面应用，但那些关于心脏瓣膜疾病的说明与ICD-8有很大的偏离。我们得出结论：（a）注册实践的重要变化可能在任何时候发生，而不仅仅是与ICD新版本的实施有关;以及（B）各国对《国际疾病分类》编码说明的修改可能相当于颠倒《国际疾病分类》手册中的说明。这些发现必须符合：在比较不同国家的死亡原因统计数据时，应考虑到死亡原因统计数据，在分析死亡原因趋势时，应考虑到基本的和促成死亡原因的统计数据。(C)1997年爱思唯尔科学公司
In 1981, the registration routines of the Swedish cause-of-death register were adjusted. The aim of this study was to assess what influence these changes in registration practice might have had on the cause of-death trends after 1981. The Eighth Revision of the International Classification of Diseases (ICD-8) was used throughout the study period (1976-1985).Significant changes in the registered number of cases were found in 13 of the 18 diagnostic groups scrutinized. Four main types of outcomes were observed: (a) the number of underlying causes increased while the number of contributing causes decreased or vice versa; (b) the number of both underlying and contributory causes changed in the same direction, due to the transfer of a diagnostic group from one ICD category to another; (c) the number of both underlying and contributory causes changed in the same direction, but not due to the transfer of. a diagnostic group; or (d) the number of either underlying or contributory causes changed, but not both. In general, the altered registration practice led to more conditions that are often considered as terminal complications to other diseases bring registered as the underlying cause of death. While most of the 1981 instructions meant a more literal application of the ICD-8, those concerning cardiac valvular diseases deviated substantially from it. We conclude that (a) important changes in registration practice may occur at any point in time, and not only in connection with the implementation of a new version of the ICD; and (b) national adaptations of the ICD coding instructions may amount to a reversal of the instructions included in the ICD manuals. These findings must bt: considered when comparing cause-of-death statistics from different countries, and both underlying and contributing cause-of-death statistics should be considered in such analyses of cause-of-death trends. (C) 1997 Elsevier Science Inc.