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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Reliability of death certificate diagnoses
Journal of Clinical Epidemiology, Volume 43, No. 12, Year 1990
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Description
Consistency between death certificates and clinical records from 5 general hospitals in Kuwait was studied for 470 deaths with the following underlying or associated causes: hypertensive (HYP), ischaemic heart diseases (IHD), cerebrovascular diseases (CVD) and diabetes mellitus (DM). Direct causes were not considered since they are of little interest analytically. Only deaths with definite or most probable ascertainment were included. One cardiologist, who was provided with the WHO criteria and relevant documents on death certification, independently reviewed the records. To test the reviewer's bias and the reliability of his judgement, an adjudication process was effected by having one senior cardiologist re-review a random subsample of 140 records. The two reviewers showed good agreement. Specific diagnoses criteria for deciding the underlying cause of death in multiple morbid conditions by the reviewer were followed. Due to possible reviewer bias, we aimed at measuring the difference between initial certifiers and the reviewer rather than measuring the diagnostic accuracy of initial certifiers in reference to the reviewer. The agreement 'index kappa showed poor agreement between original and revised certificates. The original certificates underestimated CVD as an underlying cause of death by 69.2%, DM by 60%, IHD by 33.5% and HYP by 31.8% in our sample. Associated causes were also consistently underestimated by initial certifiers as compared with the reviewer. This bias calls for basing mortality statistics in Kuwait on hospital death committees' reports rather than on initial certifier death certificates, use of multiple-causes of death instead of one underlying cause and adequate training of the medical profession on the value and process of death certification. © 1990.
Authors & Co-Authors
Moussa, Mohammad A.A.
Kuwait, Kuwait City
Kuwait University
Shafie, Mohamed Zaki
Kuwait, Safat
Chest Diseases Hospital Kuwait
Khogali, Moustafa M.
Unknown Affiliation
El Sayed, A.
Kuwait, Safat
Mubarak Al-kabeer Hospital
Sugathan, Thattaruparambil Natesan
Kuwait, Kuwait City
Kuwait University
Cherian, George
Kuwait, Safat
Chest Diseases Hospital Kuwait
Abdel-khalik, Al Zook H.
Kuwait, Safat
Mubarak Al-kabeer Hospital
Garada, Mohamed T.
Kuwait, Safat
Mubarak Al-kabeer Hospital
Verma, D.
Kuwait, Safat
Mubarak Al-kabeer Hospital
Statistics
Citations: 43
Authors: 9
Affiliations: 3
Identifiers
Doi:
10.1016/0895-4356(90)90094-6
ISSN:
08954356
Research Areas
Health System And Policy
Noncommunicable Diseases