caa a22 4500 397576978 CHVBK 20180308164858.0 cr unu---uuuuu 161202e199603 xx s 000 0 eng 10.1093/oxfordjournals.pubmed.a024463 doi (NATIONALLICENCE)oxford-10.1093/oxfordjournals.pubmed.a024463 ‘Inaccuracy' in death certification - where are we now? [Elektronische Daten] [G. Maudsley, E. M. I. Williams] Background This review aims to document and analyse aspects of death certification that are relevant to public health. Methods A literature review on death certification primarily used the computerized Index Medicus (1981 to mid 1995), and concentrated on completing death certificates, accuracy, standards, education and procedural requirements. Further sentinel publications pre-dating this were identified from the main literature base. Resutts The uses of mortality data, historical and procedural context for recording death, the philosophy of Underlying Cause of Death and its relationship to ‘the truth', the extent and impact of ‘inaccuracy', the certificate and the certifier, and possible ways forward are discussed. It is argued that the question ‘How inaccurate are cause of death data?' is harder to answer than the literature suggests. Deriving a useful estimate is difficult because of inter-study differences in (1) definition, measurement (how and by whom?) and practical importance of error, and standards used; (2) focus (e.g. death certificate or mortality data), observing everyday practice or simulation exercises, diagnostic and/or semantic issues. Conclusion The traditional perspective on improving the quality of death certification has not worked. There is a need for reorientated thinking rather than just urging more education. Evidence-based educational interventions are needed. The flaws in the theoretical framework of cause of death and the routine nature of death certification are unavoidable, but require consideration. Certifiers need practical feedback mechanisms, integral to continuing quality assurance at all levels and fostering an understanding of the construction of mortality data. Continued development should be a core public health medicine role. © Oxford University Press Articles nationallicence medical education nationallicence semantics nationallicence standards nationallicence Underlying Cause of Death nationallicence Maudsley G. Department of Public Health, University of Liverpool, Whelan Building, P.O. Box 147, Liverpool L69 3BX aut Williams E. M. I. Department of Public Health, University of Liverpool, Whelan Building, P.O. Box 147, Liverpool L69 3BX aut Journal of Public Health Oxford University Press 18/1(1996-03), 59-66 1741-3842 18:1<59 1996 18 pubmed https://doi.org/10.1093/oxfordjournals.pubmed.a024463 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/oxfordjournals.pubmed.a024463 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Maudsley G. Department of Public Health, University of Liverpool, Whelan Building, P.O. Box 147, Liverpool L69 3BX aut NATIONALLICENCE 700 1- Williams E. M. I. Department of Public Health, University of Liverpool, Whelan Building, P.O. Box 147, Liverpool L69 3BX aut NATIONALLICENCE 773 0- Journal of Public Health Oxford University Press 18/1(1996-03), 59-66 1741-3842 18:1<59 1996 18 pubmed Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford