Revisiting the mortality of France and Italy with the multiple-cause-of-death approach

Désesquelles, Aline; Salvatore, Michele Antonio; Frova, Luisa; Pace, Monica; Pappagallo, Marilena; Egidi, Viviana

doi:10.4054/demres.2010.23.28

Cited by 31 publications

(51 citation statements)

References 30 publications

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“…In particular, we confirmed the findings of previous studies that some conditions that are rarely designated as the underlying cause of death actually make a substantial contribution to mortality: namely, diabetes, 3 , 17 , 18 skin disease, blood disease 9 , 19 and renal disease 1 , 3 , 7 . However, as previously observed, 3 the increase in the standardized mortality rate we found for each condition varied widely with the disease category.…”

Section: Discussionsupporting

confidence: 92%

Quantifying cause-related mortality by weighting multiple causes of death

Piffaretti

Moreno‐Betancur

Lamarche-Vadel

et al. 2016

Bull World Health Organ

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ObjectiveTo investigate a new approach to calculating cause-related standardized mortality rates that involves assigning weights to each cause of death reported on death certificates.MethodsWe derived cause-related standardized mortality rates from death certificate data for France in 2010 using: (i) the classic method, which considered only the underlying cause of death; and (ii) three novel multiple-cause-of-death weighting methods, which assigned weights to multiple causes of death mentioned on death certificates: the first two multiple-cause-of-death methods assigned non-zero weights to all causes mentioned and the third assigned non-zero weights to only the underlying cause and other contributing causes that were not part of the main morbid process. As the sum of the weights for each death certificate was 1, each death had an equal influence on mortality estimates and the total number of deaths was unchanged. Mortality rates derived using the different methods were compared.FindingsOn average, 3.4 causes per death were listed on each certificate. The standardized mortality rate calculated using the third multiple-cause-of-death weighting method was more than 20% higher than that calculated using the classic method for five disease categories: skin diseases, mental disorders, endocrine and nutritional diseases, blood diseases and genitourinary diseases. Moreover, this method highlighted the mortality burden associated with certain diseases in specific age groups.ConclusionA multiple-cause-of-death weighting approach to calculating cause-related standardized mortality rates from death certificate data identified conditions that contributed more to mortality than indicated by the classic method. This new approach holds promise for identifying underrecognized contributors to mortality.

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Section: Discussionsupporting

confidence: 92%

Quantifying cause-related mortality by weighting multiple causes of death

Piffaretti

Moreno‐Betancur

Lamarche-Vadel

et al. 2016

Bull World Health Organ

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“…Désesquelles et al (2010Désesquelles et al ( , 2012) present a thorough discussion of certification and coding errors affecting Italian multicause mortality data and their possible impact on multicause mortality rates and relationships between causes. Additionally, Désesquelles et al (2010Désesquelles et al ( , 2014Désesquelles et al ( , 2015 address specific causes of death, dealing respectively with cancer, Alzheimer's disease, and infectious diseases. In light of existing evidence that Italian MCOD data is of relatively high quality, we have confidence in the reliability of our results.…”

Section: Discussionmentioning

confidence: 99%

“…With the increasing use of automated coding systems to capture information from death certificates, data on both underlying and contributing causes is now widely available, and many studies are exploring the added value of the MCOD approach in analyzing mortality risks. As described in Désesquelles et al (2010), the MCOD approach contributes in multiple ways to mortality analysis: capturing a country's mortality profile (Manton and Stallard 1982;Manton 1986;Manton and Myers 1987;Mackenbach et al 1995;Stallard 2002;Désesquelles and Meslé 2004;Redelings, Sorvillo, and Simon 2006;Redeling, Wise, and Sorvillo 2007;Frova et al 2009); reevaluating the contribution of a specific cause (Wing and Manton 1981;Nizard and Munoz-Pérez 1993;Coste and Jougla 1994;Wise and Sorvillo 2005;Fuhrman et al 2006;Romon et al 2008;Désesquelles et al 2015); and studying the medical circumstances surrounding the deaths of elderly people and relationships between causes of death (Désesquelles et al 2012(Désesquelles et al , 2014. The present paper focuses on this last issue in order to better understand the system of relationships among causes of death for older men and women in Italy.…”

Section: Introduction and Objectivesmentioning

confidence: 99%

“…In so doing, we also address an important limitation in existing studies: the neglect of multiple relationships among causes of death and the crucial role that some of these may play in the death process. There is evidence that relations among causes of death are too complex to be captured by current MCOD indicators (Désesquelles et al 2010(Désesquelles et al , 2012(Désesquelles et al , 2014(Désesquelles et al , 2015. A focus on relationships between underlying and contributing causes may hide important relationships among contributing causes that affect the death process, as well as preventing the identification of diseases and conditions that play an active role in pathological patterns.…”

Section: Introduction and Objectivesmentioning

confidence: 99%

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A network approach to studying cause-of-death interrelations

Egidi¹,

Salvatore²,

Rivellini³

et al. 2018

DemRes

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BACKGROUNDMultiple causes of death describe complex death processes marked by the simultaneous presence of several diseases and conditions, primarily at older ages. OBJECTIVEWe intend to explore the opportunity offered by the Social Network Analysis (SNA) in the study of multiple relationships in the causes of death. METHODSSNA allowed us to reconstruct the complex system of relationships linking the causes of death mentioned in the same death certificate for Italian men and women aged 65 years and over in 2011. The causes can be represented as actors of a network where the relational tie establishes a linkage between a cause mentioned together with another. The strength of this association is represented by the frequency of the joint mentioning in the same certificate controlling for the confounding effect due to the different prevalence of the causes. RESULTSThe analysis clearly brought out that causes of death describe a very dense system of relationships. Considering only the strongest associations, the graphical analysis showed subgroups of causes, within which cross-references are very frequent while mentions external to the group are rare. Moreover, SNA concepts and instruments allowed us to identify causes playing important roles in death processes and mortality patterns.1 Sapienza Università di Roma, Rome, Italy. 2 Istituto Nazionale di Statistica (ISTAT), Rome, Italy. 3 Università Cattolica del Sacro Cuore, Milan, Italy. Email: giulia.rivellini@unicatt.it. Egidi et al.:A network approach to studying cause-of-death interrelations 374http://www.demographic-research.org CONCLUSIONS SNA has proved to be very powerful in identifying the relationships between causes of death, on which health policies should take action to further reduce mortality risks of elderly persons. CONTRIBUTIONThe method was able to highlight complex structures composing subgroups of diseases, offering a clearer picture of the characteristics of death processes than the analyses conducted so far have allowed.

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“…Therefore, using the current 1-cause-to-1-death model for cause-of-death coding might not be appropriate when describing mortality among persons aged 85 or older (24). One consideration is to use contributing and multiple cause-of-death data (ie, all the clinical conditions and events listed on the death certificate) when analyzing mortality data among this age group (26,27). …”

Section: Discussionmentioning

confidence: 99%

Impact of a Hospital-Level Intervention to Reduce Heart Disease Overreporting on Leading Causes of Death

Al-Samarrai¹,

Madsen²,

Zimmerman³

et al. 2013

Prev. Chronic Dis.

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IntroductionThe quality of cause-of-death reporting on death certificates affects the usefulness of vital statistics for public health action. Heart disease deaths are overreported in the United States. We evaluated the impact of an intervention to reduce heart disease overreporting on other leading causes of death.MethodsA multicomponent intervention comprising training and communication with hospital staff was implemented during July through December 2009 at 8 New York City hospitals reporting excessive heart disease deaths. We compared crude, age-adjusted, and race/ethnicity-adjusted proportions of leading, underlying causes of death reported during death certification by intervention and nonintervention hospitals during preintervention (January–June 2009) and postintervention (January–June 2010) periods. We also examined trends in leading causes of death for 2000 through 2010.ResultsAt intervention hospitals, heart disease deaths declined by 54% postintervention; other leading causes of death (ie, malignant neoplasms, influenza and pneumonia, cerebrovascular disease, and chronic lower respiratory diseases) increased by 48% to 232%. Leading causes of death at nonintervention hospitals changed by 6% or less. In the preintervention period, differences in leading causes of death between intervention and nonintervention hospitals persisted after controlling for race/ethnicity and age; in the postintervention period, age accounted for most differences observed between intervention and nonintervention hospitals. Postintervention, malignant neoplasms became the leading cause of premature death (ie, deaths among patients aged 35–74 y) at intervention hospitals.ConclusionA hospital-level intervention to reduce heart disease overreporting led to substantial changes to other leading causes of death, changing the leading cause of premature death. Heart disease overreporting is likely obscuring the true levels of cause-specific mortality.

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Revisiting the mortality of France and Italy with the multiple-cause-of-death approach

Cited by 31 publications

References 30 publications

Quantifying cause-related mortality by weighting multiple causes of death

Quantifying cause-related mortality by weighting multiple causes of death

A network approach to studying cause-of-death interrelations

Impact of a Hospital-Level Intervention to Reduce Heart Disease Overreporting on Leading Causes of Death

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