| Title: |
Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records |
| Authors: |
Chen, L; Xia, T; Yuan, ZA; Rampatige, R; Chen, J; Li, H; Adair, T; Yu, HT; Bratschi, M; Setel, P; Rajasekhar, M; Chowdhury, HR; Gamage, SH; Fang, B; Azam, O; Santon, R; Gu, Z; Tan, Z; Wang, C; Lopez, AD; Wu, F |
| Publisher Information: |
BMJ PUBLISHING GROUP |
| Publication Year: |
2022 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
OBJECTIVES: To assess the quality of cause of death reporting in Shanghai for both hospital and home deaths. DESIGN AND SETTING: Medical records review (MRR) to independently establish a reference data set against which to compare original and adjusted diagnoses from a sample of three tertiary hospitals, one secondary level hospital and nine community health centres in Shanghai. PARTICIPANTS: 1757 medical records (61% males, 39% females) of deaths that occurred in these sample sites in 2017 were reviewed using established diagnostic standards. INTERVENTIONS: None. PRIMARY OUTCOME: Original underlying cause of death (UCOD) from medical facilities. SECONDARY OUTCOME: Routine UCOD assigned from the Shanghai Civil Registration and Vital Statistics (CRVS) system and MRR UCODs from MRR. RESULTS: The original UCODs as assigned by doctors in the study facilities were of relatively low quality, reduced to 31% of deaths assigned to garbage codes, reduced to 2.3% following data quality and follow back procedures routinely applied by the Shanghai CRVS system. The original UCOD had lower chance-corrected concordance and cause-specific mortality fraction accuracy of 0.57 (0.44, 0.70) and 0.66, respectively, compared with 0.75 (0.66, 0.85) and 0.96, respectively, after routine data checking procedures had been applied. CONCLUSIONS: Training in correct death certification for clinical doctors, especially tertiary hospital doctors, is essential to improve UCOD quality in Shanghai. A routine quality control system should be established to actively track diagnostic performance and provide feedback to individual doctors or facilities as needed. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
2044-6055 |
| Relation: |
https://hdl.handle.net/11343/301665 |
| Availability: |
https://hdl.handle.net/11343/301665 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0 ; CC BY-NC |
| Accession Number: |
edsbas.3F3D9C32 |
| Database: |
BASE |