Multiple sclerosis and motor neurone disease: survival and how certified after death.

O’Malley, Frances P.; Dean, Geoffrey; Elian, Marta

doi:10.1136/jech.41.1.14

Cited by 57 publications

(35 citation statements)

References 7 publications

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“…The different variability that stems from the ranges of survival (table 1) in the north and south of Italy are comparable with previous surveys where patients were followed for shorter periods of time [11,13,18].…”

Section: Discussionsupporting

confidence: 71%

“…TPR for the total study sample was even lower than that of other studies done in Italy [5] and other countries [2,3,6,10,13].…”

Section: Discussioncontrasting

confidence: 38%

“…In the last decades, some surveys on amyotrophic lateral sclerosis (ALS) have showed increasing rates of mortality in several countries [2,6,12,13] and geographical variations have also been reported [1].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Accuracy of Death Certificates for Amyotrophic Lateral Sclerosis Varies Significantly from North to South of Italy: Implications for Mortality Studies

et al. 2004

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Objective: To evaluate the accuracy of death certificates (DCs) for amyotrophic lateral sclerosis (ALS) in different parts of Italy. Studies based on DC diagnosis for ALS have shown a reduced mortality comparing northern with southern Italy. These data are in contrast with results from other surveys on the incidence of ALS performed in Italy and other countries. Methods: Archives of neurological clinics from northern (Milano, Monza, Pavia, and Bologna) and southern Italy including islands (Napoli, Sassari, Palermo, and Messina) were searched for patients discharged with a diagnosis of ALS in the period 1970–1995. Subjects affected by definite/probable ALS according to the Scottish Motor Neuron Disease Research Group diagnostic criteria were included. DCs were obtained from the vital statistic bureau. True positive rates (TPRs) and 95% confidence intervals (CIs) for proportions were calculated for northern and southern Italy separately. Multiple logistic regression analysis was performed according to gender, age at onset, age and year of death, and interval between onset and death. Results: We found 651 patients affected by definite/probable ALS; 573 of them had died by December 31, 1996. DCs were available for 566 subjects (411 from northern Italy and 155 from southern Italy). TPR was 66.7% (95% CI 61.9–71.2) for northern Italy and 51.6% (95% CI 43.5–59.7) for southern Italy (χ² = 10.9, p = 0.001). Logistic regression analysis showed an association between a lower accuracy of DCs and the interval between onset of symptoms and death. TPR calculations considering different death periods (1970–1982 and 1983–1996) showed comparable rates of accuracy over time. Conclusions: Mortality statistics based on official death records do not accurately reflect interregional mortality for ALS in Italy.

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Section: Discussionsupporting

confidence: 71%

“…TPR for the total study sample was even lower than that of other studies done in Italy [5] and other countries [2,3,6,10,13].…”

Section: Discussioncontrasting

confidence: 38%

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Accuracy of Death Certificates for Amyotrophic Lateral Sclerosis Varies Significantly from North to South of Italy: Implications for Mortality Studies

et al. 2004

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“…This study design is often used to investigate long-term or geographical distribution of diseases. Surveys of motor neuron disease (MND) mortality conducted over the past decades have shown rising rates in several countries [1][2][3][4]. The presence of some geographical variation in MND mortality has also been reported [1,5].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Death Certificates for Motor Neuron Disease and Multiple Sclerosis in the Province of Palermo in Southern Italy

Ragonese

Salemi²,

Aridon³

et al. 2002

Neuroepidemiology

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Mortality studies based on death certificates (DCs) are relatively inexpensive and easy to conduct. Therefore, they are frequently used to evaluate variations of geographical and temporal patterns, particularly in uncommon diseases. Recent surveys of motor neuron disease (MND) and multiple sclerosis (MS) based on official mortality statistics in Italy showed a decreasing trend of mortality from northern to southern Italy. To evaluate if DCs are homogeneously recorded in Italy and whether or not they can be considered a good instrument for mortality studies, we assessed the accuracy of DCs for MND and MS in the province of Palermo, Italy, and compared our results with those reported in other studies. We searched the archives of the neurological clinic of the University of Palermo for patients affected by one of the two diseases who were residents and were diagnosed in Palermo province. We found 157 patients with definite MND and 360 with clinically definite MS. Seventy-eight out of the 157 MND patients and 43 out of the 360 MS patients had died. Considering the underlying cause of death, the true-positive rate was 48% [95% confidence interval (CI) 36–60%] for MND and 46% (95% Cl 30–62%) for MS. The rates we found for MND were lower than those reported either in Italy or worldwide. This result suggests caution in formulating gradient hypotheses for MND. Concerning MS, the rate we found was low, but similar to that found by others. This indicates that a mortality survey of MS based on DCs is unlikely to be contributory.

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“…The accuracy of death certification of MND in Spain has not been assessed. However, studies elsewhere have reported accuracy rates consistently greater than 80% [26,27], attributed to the short duration and high lethality of the disease.…”

Section: Methodsmentioning

confidence: 99%

Decline and Rise of Mortality from Motor Neuron Disease in Spain, 1960-1989: Demographic, Environmental and Competitive Influences

et al. 1996

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Mortality rates from motor neuron disease (MND) in Spain were analysed for the years 1960–1989, a period in which 3,530 deaths were recorded from the disease and during which the crude annual mortality rate ranged between 0.35 and 0.95 deaths per 100,000 persons. Whilst the crude mortality rate fell by 54% during the decade 1960–1969, there was a net increase of 26% over the entire period. The influence of three sets of variables – the increasing mean age of the population, changing environmental factors, and changing competition between diseases – upon mortality rates were investigated through Gompertzian analysis of crude and age-adjusted mortality rates. The increased mean age of the population contributed significantly to the overall rise in mortality from MND over the whole period, a feature that has previously been demonstrated to occur in the majority of industrialised countries. The unusual pattern of a decline and subsequent rise in mortality appears to be due to the influence of changing environmental factors on a sub-population susceptible to the disease.

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Multiple sclerosis and motor neurone disease: survival and how certified after death.

Cited by 57 publications

References 7 publications

Accuracy of Death Certificates for Amyotrophic Lateral Sclerosis Varies Significantly from North to South of Italy: Implications for Mortality Studies

Accuracy of Death Certificates for Amyotrophic Lateral Sclerosis Varies Significantly from North to South of Italy: Implications for Mortality Studies

Accuracy of Death Certificates for Motor Neuron Disease and Multiple Sclerosis in the Province of Palermo in Southern Italy

Decline and Rise of Mortality from Motor Neuron Disease in Spain, 1960-1989: Demographic, Environmental and Competitive Influences

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