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Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records

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 hospi...

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Autores principales: Chen, Lei, Xia, Tian, Yuan, Zheng-An, Rampatige, Rasika, Chen, Jun, Li, Hang, Adair, Timothy, Yu, Hui-Ting, Bratschi, Martin, Setel, Philip, Rajasekhar, Megha, Chowdhury, H R, Gamage, Saman Hattotuwa, Fang, Bo, Azam, Omair, Santon, Romain, Gu, Zhen, Tan, Ziwen, Wang, Chunfang, Lopez, Alan D, Wu, Fan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8852669/
https://www.ncbi.nlm.nih.gov/pubmed/35168960
http://dx.doi.org/10.1136/bmjopen-2020-046185
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author Chen, Lei
Xia, Tian
Yuan, Zheng-An
Rampatige, Rasika
Chen, Jun
Li, Hang
Adair, Timothy
Yu, Hui-Ting
Bratschi, Martin
Setel, Philip
Rajasekhar, Megha
Chowdhury, H R
Gamage, Saman Hattotuwa
Fang, Bo
Azam, Omair
Santon, Romain
Gu, Zhen
Tan, Ziwen
Wang, Chunfang
Lopez, Alan D
Wu, Fan
author_facet Chen, Lei
Xia, Tian
Yuan, Zheng-An
Rampatige, Rasika
Chen, Jun
Li, Hang
Adair, Timothy
Yu, Hui-Ting
Bratschi, Martin
Setel, Philip
Rajasekhar, Megha
Chowdhury, H R
Gamage, Saman Hattotuwa
Fang, Bo
Azam, Omair
Santon, Romain
Gu, Zhen
Tan, Ziwen
Wang, Chunfang
Lopez, Alan D
Wu, Fan
author_sort Chen, Lei
collection PubMed
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.
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spelling pubmed-88526692022-03-03 Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records Chen, Lei Xia, Tian Yuan, Zheng-An Rampatige, Rasika Chen, Jun Li, Hang Adair, Timothy Yu, Hui-Ting Bratschi, Martin Setel, Philip Rajasekhar, Megha Chowdhury, H R Gamage, Saman Hattotuwa Fang, Bo Azam, Omair Santon, Romain Gu, Zhen Tan, Ziwen Wang, Chunfang Lopez, Alan D Wu, Fan BMJ Open Public Health 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. BMJ Publishing Group 2022-02-15 /pmc/articles/PMC8852669/ /pubmed/35168960 http://dx.doi.org/10.1136/bmjopen-2020-046185 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Public Health
Chen, Lei
Xia, Tian
Yuan, Zheng-An
Rampatige, Rasika
Chen, Jun
Li, Hang
Adair, Timothy
Yu, Hui-Ting
Bratschi, Martin
Setel, Philip
Rajasekhar, Megha
Chowdhury, H R
Gamage, Saman Hattotuwa
Fang, Bo
Azam, Omair
Santon, Romain
Gu, Zhen
Tan, Ziwen
Wang, Chunfang
Lopez, Alan D
Wu, Fan
Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records
title Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records
title_full Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records
title_fullStr Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records
title_full_unstemmed Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records
title_short Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records
title_sort are cause of death data for shanghai fit for purpose? a retrospective study of medical records
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8852669/
https://www.ncbi.nlm.nih.gov/pubmed/35168960
http://dx.doi.org/10.1136/bmjopen-2020-046185
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