Methods and tools to evaluate the quality of vital statistics
Ill-defined causes of deaths
This section outlines other key issues that can affect the quality of mortality data.
Ill-defined and poorly specified CODs. Unfortunately, not all physicians have been trained in filling out the death certificate form correctly and completely, and many are not aware of its importance. As a result, coders who receive the death certificate often assign ill-defined and poorly specified ICD codes. These codes are not useful for health purposes and thus diminish the utility of a country’s COD statistics.
In general, if 10–20 per cent of deaths are assigned such codes, you would benefit from applying one of the mortality assessment tools described in this section. These tools help reveal the most misused CODs and what effect they have on the death distribution. The higher the proportion of ill-defined and poorly specified CODs in the distribution, the higher the probability that the statistics are misleading, which can lead to faulty decision-making and the misuse of health resources.
Tabulation lists. The ICD proposes four different ways of aggregating the thousands of ICD codes that are suitable for health purposes. The Global Burden of Disease Study also has several useful lists for this purpose. When mortality data are not tabulated accordingly, it is difficult, if not impossible, for policy-makers to sift through thousands of codes to determine the leading CODs and therefore allocate resources to improve the health situation in a country. Additionally, when codes are not tabulated to an international standard, there is no basis for a regional or international comparison of a country’s mortality situation.
WHO tabulation lists: www.cdc.gov/nchs/data/dvs/im9_2002.pdf
GBD tabulation list: www.ncbi.nlm.nih.gov/books/NBK11808/table/A351