M de Arán Barés1, G Pérez, J Rosell, P Molina. 1. Registre de Mortalitat de Catalunya, Servei d'Informació i Estudis, Departament de Sanitat i Seguretat Social, Trav. de les Corts 131-159, pavelló Ave María, 08028-Barcelona.
Abstract
OBJECTIVE: Deaths due to external and natural causes with forensic intervention require medical-legal autopsy. In order to be included in the mortality statistics the results are reported in the statistical document MNP52. The accuracy of cause of death depends on the characteristics of the document, the point at which it is completed (after the death or after the autopsy) and the person that completes it. The objective is to determine the accuracy of external and natural causes of death with forensic intervention, reported in the official statistical documents by a medical-legal autopsy report of these deaths occurred in Catalonia in 1996. METHODS: Two samplings were undertaken--one for natural causes and another for external causes--that were stratified by sex and judicial district. The information sources were the Mortality Register of Catalonia for the statistical documents and the criminal courts for the medical-legal autopsy, toxicological and pathological reports. We calculated the index of agreement, the sensitivity or detection rate (DR) and the positive predictive value of confirmation rate (CR), and their respective 95% confidence intervals. RESULTS: The index of agreement was 72.3% (IC 95%: 68.7-75.9). The DR for external causes groups was 65.9% (60.6-71.2) and the CR was 69% (63.6-71.2). For natural causes the DR was 79.4% (74.7-84.2) and the CR was 75.5% (70.7-80.5). CONCLUSION: In deaths with forensic intervention, the official statistical documents do not correctly report external causes of death, and statistics for natural causes of death approach acceptable levels of accuracy. The results are mainly due to deficits in reporting and certifying these causes in the official statistics.
OBJECTIVE: Deaths due to external and natural causes with forensic intervention require medical-legal autopsy. In order to be included in the mortality statistics the results are reported in the statistical document MNP52. The accuracy of cause of death depends on the characteristics of the document, the point at which it is completed (after the death or after the autopsy) and the person that completes it. The objective is to determine the accuracy of external and natural causes of death with forensic intervention, reported in the official statistical documents by a medical-legal autopsy report of these deaths occurred in Catalonia in 1996. METHODS: Two samplings were undertaken--one for natural causes and another for external causes--that were stratified by sex and judicial district. The information sources were the Mortality Register of Catalonia for the statistical documents and the criminal courts for the medical-legal autopsy, toxicological and pathological reports. We calculated the index of agreement, the sensitivity or detection rate (DR) and the positive predictive value of confirmation rate (CR), and their respective 95% confidence intervals. RESULTS: The index of agreement was 72.3% (IC 95%: 68.7-75.9). The DR for external causes groups was 65.9% (60.6-71.2) and the CR was 69% (63.6-71.2). For natural causes the DR was 79.4% (74.7-84.2) and the CR was 75.5% (70.7-80.5). CONCLUSION: In deaths with forensic intervention, the official statistical documents do not correctly report external causes of death, and statistics for natural causes of death approach acceptable levels of accuracy. The results are mainly due to deficits in reporting and certifying these causes in the official statistics.
Authors: Rasika Rampatige; Lene Mikkelsen; Bernardo Hernandez; Ian Riley; Alan D Lopez Journal: Bull World Health Organ Date: 2014-09-16 Impact factor: 9.408