A mixed-methods prospective study of death certification in general practice

O'Donovan, Barry G. G.; Armstrong, Paul C; Byrne, Mary; Murphy, Andrew W.

doi:10.1093/fampra/cmq012

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…It is much more important to capture the uncertainties and range of opinions, handle these data epidemiologically, and so enable them to be included in public health thinking. This is an important difference of principle from ICD-10's exclusion of capturing uncertainty at the individual underlying cause code level (even though physicians may admit to being uncertain at the certification stage [16,17]).…”

Section: Discussionmentioning

confidence: 99%

The democratic fallacy in matters of clinical opinion: implications for analysing cause-of-death data

Byass

2011

Emerg Themes Epidemiol

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Arriving at a consensus between multiple clinical opinions concerning a particular case is a complex issue - and may give rise to manifestations of the democratic fallacy, whereby a majority opinion is misconstrued to represent some kind of "truth" and minority opinions are somehow "wrong". Procedures for handling multiple clinical opinions in epidemiological research are not well established, and care is needed to avoid logical errors. How to handle physicians' opinions on cause of death is one important domain of concern in this respect. Whether multiple opinions are a legal requirement, for example ahead of cremating a body, or used for supposedly greater rigour, for example in verbal autopsy interpretation, it is important to have a clear understanding of what unanimity or disagreement in findings might imply, and of how to aggregate case data accordingly.In many settings where multiple physicians have interpreted verbal autopsy material, an over-riding goal of arriving at a single cause of death per case has been applied. In many instances this desire to constrain findings to a single cause per case has led to methodologically awkward devices such as "TB/AIDS" as a single cause. This has also usually meant that no sense of disagreements or uncertainties at the case level is taken forward into aggregated data analyses, and in many cases an "indeterminate" cause may be recorded which actually reflects a lack of agreement rather than a lack of data on possible cause(s).In preparing verbal autopsy material for epidemiological analyses and public health interpretations, the possibility of multiple causes of death per case, and some sense of any disagreement or uncertainty encountered in interpretation at the case level, need to be captured and incorporated into overall findings, if evidence is not to be lost along the way. Similar considerations may apply in other epidemiological domains.

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Section: Discussionmentioning

confidence: 99%

The democratic fallacy in matters of clinical opinion: implications for analysing cause-of-death data

Byass

2011

Emerg Themes Epidemiol

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“…2 However, reality evidences a relative neglect in the completion of such document, making the correct distribution of health resources throughout the country difficult. 13 The SIM, despite representing the main source of data about mortality in Brazil, with a visible annual increase in its scope, faces obstacles in improving the quality of the its data, mainly due to the inappropriate completion of its standard document, the MCOD. However, it is important to highlight that only physicians are responsible for such losses of scientific and epidemiological data.…”

Section: Discussionmentioning

confidence: 99%

Declaração de óbito, compromisso no preenchimento. Avaliação em Belém – Pará, em 2010

Silva

Yamaki

Oliveira

et al. 2013

Revista da Associação Médica Brasileira

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“…One factor that potentially limits physician performance is their awareness of the importance of death certificates and how they are used. While the literature concerning physicians' awareness is sparse, researchers have questioned whether physicians are aware of the public health importance of death certificate data [2,10,11].…”

Section: Physician Awarenessmentioning

confidence: 99%

Death certification: issues and interventions

Middleton¹,

Anderson²,

Billingsly³

et al. 2011

OJPM

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A review of the literature suggests that errors in death certification are common. We reviewed the published literature to clarify what is known and what remains to be learned before evidence-based changes in medical education can be recommended. We searched the National Library of Medicine’s PubMed database for articles that addressed death certificate accuracy and identified 159 articles of interest published from 1996 to 2010. Among these 159 articles, we found 83 that were relevant to our goals and objectives. Cause of death certification has been shown to be problematic and several interventions have been shown to improve its accuracy, especially if the intervention is interactive. However these studies have focused on short term gains rather than on long term retention and performance, leaving a significant data gap. We suggest a study design that could address this data gap

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A mixed-methods prospective study of death certification in general practice

Abstract: GPs appear to feel in an ambivalent or invidious position where death certification is required, a situation that could be addressed in postgraduate training settings.

Cited by 4 publications

References 4 publications

The democratic fallacy in matters of clinical opinion: implications for analysing cause-of-death data

The democratic fallacy in matters of clinical opinion: implications for analysing cause-of-death data

Declaração de óbito, compromisso no preenchimento. Avaliação em Belém – Pará, em 2010

Death certification: issues and interventions

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