Cause-of-death query in validation of death certification by expert panel;: effects on mortality statistics in Finland, 1995
Cause-of-death query in validation of death certification by expert panel;: effects on mortality statistics in Finland, 1995
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DOI：
10.1016/s0379-0738(02)00418-8
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发表时间：
2003-01-28
影响因子：
2.2
通讯作者：
Penttilä, A
中科院分区：
文献类型：
--
作者：
Lahti, RA;Penttilä, A
根本死因选择、编码和登记的正确性对于死亡率统计的质量非常重要。提高质量的一项措施是向认证机构询问根本死因。在芬兰，统计人员认为 1995 年有 3,478 份死亡证明存在问题，占 1995 年 49,074 份死亡证明总数的 7.1%。芬兰统计局的专家小组解决了其中 2813 个问题 (80.9%)。然而，有 665 个（19.1%）证书需要向验证者进一步查询。其中，318 例 (47.8%) 被重新分配到另一个 ICD-9 类别或心脏和血管疾病主要类别中适用的三位数类别，导致风湿性心脏病（ICD-9 代码 390-398）增加 17.00 倍，而未特指肿瘤（代码 235-239）减少约二分之一（0.45 倍变化）。然而，在任何应用的 ICD 类别中均未观察到对国家死亡率统计数据产生统计显着影响。在所有可疑的死亡证明中，最容易受到验证者质疑且统计显着性为 P < 0.05 的是那些没有明确死因的死亡证明、那些将潜在死因表述为非特定肿瘤的死亡证明（观察/预期比率 O/E 为 1.69）以及心脏和血管疾病（1.45），其子类别为缺血性心脏病（1.33）和其他心脏病（2.92）。强烈指出通过专家组咨询和向认证机构查询的死亡证明验证，以及评估死亡证明死因信息有效性的重要性，不断争取正确可靠的死亡统计。 (C) 2002 Elsevier Science Ireland Ltd. 保留所有权利。
The correctness of selection, coding and registration of underlying cause-of-death is important for the quality of mortality statistics. One measure to improve quality is the query to the certifier for verification of the underlying cause-of-death. In Finland, 3478 death certificates, 7.1% of total 49,074 certifications in 1995, were considered questionable by statisticians. The expert panel at Statistics Finland was able to resolve 2813 (80.9%) of them. However, 665 (19.1%) certificates needed to be further queried from the certifier. Of these, 318 (47.8%) were re-assigned to another ICD-9 category or to the applicable three-digit category within the main category of heart and vascular diseases, resulting in changes from a 17.00-fold increase in rheumatic heart diseases (ICD-9 codes 390-398) to a decrease of about one-half (0.45-fold change) in unspecified neoplasms (codes 235-239). However, a statistically significant impact on national mortality statistics was not observed in any of applied ICD categories. Among all questionable death certificates, most prone to query of the certifier, and with a statistical significance of P < 0.05, were those with no cause-of-death specified, those stating underlying cause-of-death as non-specified neoplasms (with a observed/expected ratio, O/E, of 1.69), and heart and vascular diseases (1.45), with its subcategories of ischaemic heart diseases (1.33) and other heart diseases (2.92). Death certificate validation, by expert panel consultations and query to the certifiers, and the importance of estimation of the validity of cause-of-death information on death certificates are strongly pointed out in a continuous strive for correct and reliable mortality statistics. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.