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The value of cause of death data

Medical certification of cause of death

Coding causes of death to statistical categories
The International Classification of Diseases

Cause of death: where there is no physician
Verbal autopsy diagnostic algorithms

Automated verbal autopsy
What is automated verbal autopsy and how does it differ from medical certification of cause of death?

Incorporating verbal autopsy into the civil registration and vital statistics system

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Medical certification of cause of death

Quality assurance

The University of Melbourne has developed a simple death certification assessment tool to facilitate periodic evaluation of the impact of COD certification training. The tool is based on commonly reported death certification errors that affect the correct identification of the sequence of events leading to death and the UCOD. These errors include:

  1. Documenting multiple causes per line in Part 1 
  2. Not reporting the time interval from onset to death
  3. Leaving blank lines within the sequence/chain of events 
  4. Use of abbreviations when certifying the COD 
  5. Illegible handwriting 
  6. Incorrect/clinically improbable sequence of events leading to death 
  7. Ill-defined condition(s) entered as the UCOD 

This tool can be used to assess the baseline level of certification accuracy and to measure the impact on certification behaviour after training. This tool can also be used to periodically assess the death certification accuracy and to provide a feedback to the certifiers. This tool is designed to assess the quality of death certification practices through checking for the presence of common errors in death certificates. This can be used to assess the quality of death certification as part of routine assessment, or to assess the training needs of physicians in designing COD certification training. This tool can also be used to evaluate the impact of death certification training.

This tool can be used by a physician  who is trained in death certification practices and understands the ICD death certification rules. The tool can also be used by a well-trained coder to assess diagnostic accuracy of physician certifiers. The tool is essentially a checklist of the most common errors that are seen on death certificates.



Read more

Health Information Systems Knowledge Hub (2009).  Promoting the periodic assessment of the quality of medical records and cause-of-death data: lessons learned from a medical records study in Sri Lanka.  University of Queensland. 

Health Information Systems Knowledge Hub (2013).  Assessing the reliability of hospital-based cause-of-death statistics: evidence-based guidelines for country application.  University of Queensland.

Purdy C (2013).  The mortality assessment for health programs (MAP) system.  Baltimore MD: Johns Hopkins Bloomberg School of Health.

Rampatige R et al. (2014).  Systematic review of statistics on causes of deaths in hospitals: Strengthening the evidence for policy-makers.  Bulletin of the World Health Organization.


Assessing the quality of death certificates: Guidance for the rapid tool
Assessing the quality of death certificates: Guidance for the rapid tool

This document provides guidance on how to use the rapid assessment tool. Information generated from the assessment would be helpful for ministry of health staff, hospital administrators, health information officers or medical record officers to determine the quality of death certificates. The tool can be used by a doctor who is trained in death certification practices and understands the ICD-10 death certification rules.

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Authors: Rampatige R, Gamage S, Richards N, Riley I, Wijesekera N.

Publication date: February 2019 (update)

Resource type: CRVS resources and tools

Related resources: Assessing the quality of death certificates: Rapid tool


Assessing the quality of death certificates: Rapid tool
Assessing the quality of death certificates: Rapid tool

This tool is designed to assess the quality of death certification practices by checking for common errors in death certificates.

Download resource (289KB)
More Info

Author: University of Melbourne

Publication date: February 2019 (update)

Resource type: CRVS resources and tools

Related resources: Assessing the quality of death certificates: Guidance for the rapid tool


Handbook for doctors on cause of death certification
Handbook for doctors on cause of death certification

These are generic guidelines about how to certify the cause of death, written for physicians and medical students, particularly in developing countries.

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Author: University of Melbourne

Publication date: March 2018 (update)

Resource type: CRVS resources and tools

Related resources: Medical certification of cause of death: Quick reference guide


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