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At least 649 records · Page 36Linked to original sources
PubMed2002

[Validity of death certificate variables in cases of death from external causes, Brazil].

OBJECTIVE: To validate variables other than the basic cause of death on death certificates from external causes of residents younger than 20 years old living in Recife, Brazil, in 1995. METHODS: A survey of death records of the Institute of Forensic in Recife was carried out in order to validate death certificate variables included in official mortality registries. Agreement analysis was performed using Kappa indexes and sensitivity. As a result of the methodology used, the study data was considered to be more consistent and therefore regarded as standard. RESULTS: Those variables forensic specialists indicated as their direct responsibility showed an excellent (gender, age, and category of violence) and good (type of accident) agreement. However, there were significant discrepancies in those variables seen as either of indirect or no forensic responsibility, such as locality and area where death took place, medical care provided and accident location. CONCLUSIONS: Data reveal a dissociation between the reasons for including some variables in death certificates and the obtaining strategy and their social purpose.

Adolescent↗
PubMedDate not supplied

[Validity of information on occupation and principal cause on death certificates in Botucatu, Sao Paulo].

The aim of this paper was to evaluate the accuracy of data on death certificates for occupation and main cause of death. Measure of agreement was assessed comparing data from death certificates with those from both medical records and next-of-kin interviews, analyzing information for 552 residents of Botucatu, Southeast Brazil, who died in 1997. Kappa coefficients of 0.31 (95% C.I. 0. 29-0.34) and 0.76 (95% C.I. 0.75-0.76) were obtained for data on occupation and main cause of death, coded by a Brazilian two-digit classification and the three-digit ICD-10 classification, respectively. One can conclude that, although quality of the main cause of death is acceptable for pilot studies, data on occupation taken only from death certificates is not accurate enough to be used in epidemiological research.

Brazil↗
PubMed2004

[Reliability and validity of uterine cancer death certificates in the municipality of Belém, Pará, Brazil].

Belém, Pará State, Brazil, presents high mortality rates for uterine cervical cancer, thus justifying an analysis of the reliability and validity of data on this underlying cause of death. Death certificates for Belém residents who died in 1998-1999 from neoplasms of the uterine cervix, uterine body, or unspecified uterine site, or with mention of such a neoplasm on any line in the death certificate, were selected, amounting to 188 death certificates (DCs). All DCs were submitted to new coding, and reliability analysis was performed by simple agreement and Cohen's kappa. The underlying cause of death, established after review of medical records and/or histopathological findings, was considered the gold standard for analysis of criteria validity, based on the positive predictive value. We observed a simple agreement of 94.0% and kappa of 0.87, suggesting high reliability of the official system's coding of uterine cancer as the underlying cause of death. In the validity analysis, 120 of the 127 deaths originally considered as caused by cancer of the uterine cervix and 3 of the 4 coded as cancer of the uterine body were confirmed. An 11.2% increase in uterine cervical tumors and a reduction of 62.5% in unspecified uterine tumors were observed.

Adult↗
PubMed2005

Validity of maternal and perinatal risk factors reported on fetal death certificates.

We sought to estimate the accuracy, relative to maternal medical records, of perinatal risk factors recorded on fetal death certificates. We conducted a validation study of fetal death certificates among women who experienced fetal deaths between 1996 and 2001. The number of previous births, established diabetes, chronic hypertension, maternal fever, performance of autopsy, anencephaly, and Down syndrome had very high accuracy, while placental cord conditions and other chromosomal abnormalities were reported inaccurately. Additional population-based studies are needed to identify strategies to improve fetal death certificate data.

Cause of Death↗
PubMed1984

Birth complication reporting: the effect of birth certificate design.

The completeness of reporting of selected birth complications and congenital malformations on the Washington State birth certificate was estimated by comparing the total occurrences reported on birth certificates to the totals reported in hospital records. Two time periods were studied (1977-78 and 1980-81 before and after changes in birth certificate design). The design change (inclusion of a series of check boxes for conditions) was found to provide more complete reporting of birth complications.

Birth Certificates↗
PubMed1988

The accuracy of industry data from death certificates for workplace homicide victims.

This study compared death certificate data on usual industry for workplace homicide victims in five urban Texas counties, with medical examiners' data on the industries where victims were working when injured. The overall positive predictive value of the death certificate data was 72 per cent. Death certificate data on usual industry underestimated the number of victims working in high-risk industries when injured, partly because of victims whose usual industry was recorded as student, housewife, or military personnel.

Death Certificates↗
PubMed1989

Quality of death certificates in Valencia, Spain.

Certificates of 1,454 deaths occurring over 11 months were retrieved from the Civil Register in Valencia, Spain. Relevant medical information was systematically gathered from hospital records, questionnaires, and Coroner reports. We compared the underlying cause of death (UCD) from the original death certificate, and a reference cause of death (RCD) determined by a panel of experts based on all available information. Overall, 80.2 percent of the certificates were concordant for disease category, but there was a great disparity among some specific disease categories.

Cause of Death↗
PubMed2002

Effect of racial/ethnic misclassification of American Indians and Alaskan Natives on Washington State death certificates, 1989-1997.

OBJECTIVES: This study examined effects of racial/ethnic misclassification of American Indians and Alaskan Natives on Washington State death certificates. METHODS: Probabilistic record linkage were used to match the 1989-1997 state death files to the Northwest Tribal Registry. RESULTS: We identified matches for 2819 decedents, including 414 (14.7%) who had been misclassified as non-American Indians and Alaskan Natives on the death certificates. The likelihood of being correctly classified increased 3-fold for each higher level of American Indian and Alaskan Native ancestry (odds ratio = 2.88; 95% confidence interval [CI] = 2.51, 3.30) and decreased by 6.9% per calendar year (95% CI = 2.0, 11.5). CONCLUSIONS: Systematic biases on death certificates in Washington State persist. Methods to reduce misclassification can improve data quality and enhance efforts to measure and reduce racial/ethnic health disparities.

Alaska↗
PubMed2005

Post-master's certificate in nursing education.

With the continued shortage of nursing faculty, schools of nursing need short yet effective means of preparing educators to teach in their programs. One such strategy is a post-master's certificate in nursing education. This article describes the courses, learning activities, and outcomes of a post-master's certificate program in nursing education. Twenty-five graduates, randomly selected from the 53 who had completed the program, were interviewed. The findings indicated that a post-master's certificate was an effective strategy for preparing nurse educators and meeting the demands for more faculty in a short period of time.

Certification↗
PubMed2006

Deaths attributed to X-ray contrast media on U.S. death certificates.

OBJECTIVE: The objectives of our study were to determine the number, rate, and types of deaths attributed to specific X-ray contrast media on the basis of U.S. death certificates and to attempt to assess the comparative safety of commonly used diagnostic X-ray contrast agents using death certificate information. CONCLUSION: From 1999 through 2001, deaths attributed to the International Classification of Diseases (ICD) code for contrast media occurred at the rate of 1.1-1.2 per million contrast media packages distributed. An analysis of 1999 death certificates indicated that most deaths attributed to contrast media predictably were associated with renal failure or nephropathy and anaphylaxis or allergic reactions. Risk assessment of the comparative safety of classes or agents was limited by lack of specific contrast media names. Names of administered contrast agents should be recorded in patients' medical records and communicated to primary care physicians and certifiers of death in the event of serious sequelae after an identified recent radiologic procedure.

Cause of Death↗
PubMed1984

Completeness of the Swedish Cancer Register. Non-notified cancer cases recorded on death certificates in 1978.

Of the death certificates issued in Sweden in 1978 and stating cancer as the underlying or contributory cause of death, 1634 cases were unrecorded in the national cancer register. In 62 per cent of the cases the criteria for cancer registration were fulfilled. The non-reported cases represented a total deficit of 4.5 per cent calculated on cancer deaths in 1978. The factors responsible for the deficit were investigated. When the diagnosis had been histologically/cytologically confirmed the deficit was less than 2 per cent but was about 30 per cent when the diagnostic basis was only clinical. More than half of the non-notified cancer patients were older than 75 years. Exclusion of this age group and of myeloma and leukaemia cases gave a cancer-register deficit of 2.3 per cent. Non-notification to the Swedish cancer registry can be diminished by supplementation with data from death certificates, as practised in other Nordic countries. On regional basis these death certificates will now be collected and used as a supplement to the cancer notification in Sweden.

Adolescent↗
PubMedDate not supplied

Computer-based testing in family practice certification and recertification.

BACKGROUND: The member boards of the American Board of Medical Specialties have agreed to expand the scope of certification to include assessment of medical knowledge, practice-based learning and improvement, patient care, interpersonal and communication skills, systems-based practice, and professionalism. Multiple-choice examinations provide limited ability to assess these dimensions. METHODS: The American Board of Family Practice (ABFP) has developed a computer simulation system to facilitate more comprehensive candidate evaluation. The system consists of a knowledge base, a simulation program to create patient scenarios, an interface for presenting simulations to users, and an administrative database to track candidate performance and interactions with the system. The system uses population distributions for disease states to produce cases and evolves patients in response to candidate interventions, such as pharmacological and nonpharmacological therapies. We use Bayesian belief networks to model patient characteristics and comorbid condition interactions. RESULTS: Simulations have been created for 7 disease states; ultimately simulations will be available for 25 to 30 disease states. Initial testing will take place in regional examination centers but will ultimately use the Internet for convenient access for certification and recertification candidates. CONCLUSION: The ABFP will begin field-testing the system in early 2003 and will include simulations in the certification and recertification examination process in 2004.

Bayes Theorem↗
PubMed1988

Certification: serving the public interest.

The certification program has undergone an exciting change. The AOTA leadership and AOTA members are to be applauded for making this important step. The AOTCB is still a fledgling organization; nonetheless, it has already made great strides in carrying out its mission. The AOTCB will continue to build on the very excellent foundation AOTA has laid for the certification program. The AOTCB welcomes questions, comments, and suggestions concerning the certification program. To contact AOTCB, write to AOTCB, 1383 Piccard Drive, Rockville, MD 20850-4375 or call (301) 948-9626.

Certification↗
PubMed1991

Certification and recertification: one approach to professional accountability.

Professional accountability requires a self-regulating profession to set and maintain credible, useful standards for its members. Voluntary certification and recertification--evaluation by peers--serves the responsibility of the profession to establish and enforce its own standards. The goal of certification by the American Board of Internal Medicine is to improve the quality of medical care by ensuring that the certified internist and subspecialist possess the knowledge, skills, and attitudes essential to the provision of excellent care. Without a true constituency and with a valid certification process, the Board provides a credential sought by nearly every graduate resident and acceptable both to the profession and patients. Recertification now presents the opportunity to foster continuing scholarship and self-improvement throughout the career of an internist.

Certification↗
PubMed1995

Competency-Based Certification Project. Phase III: content validity, standard setting and criterion-related validity.

This is the final article in a three-part series explaining the CAMRT's Competency-Based Certification Project--an effort to make the Association's certification process more job-relevant. The first article (Journal, August 1994) explained the job analysis process used to specify and validate the list of duties and tasks required of entry-level medical radiation technologists, the imaging and treatment procedures they perform, and the equipment they use. The second article (Journal, October 1994) explained the process for developing an examination blueprint by reviewing the CAMRT's examinations and summaries of clinical experience in the context of competency-based evaluation and the job analysis validation in each discipline. This article examines the development of assessment standards for certification examinations and summaries of clinical experience. It provides an overview of the steps necessary to develop a valid and defensible licensure/certification process after development of the examination content is complete.

Canada↗
PubMed1995

Home health agency quality: Medicare certification findings compared to patient outcomes.

As part of an evaluation of the Medicare certification program for home health agencies (HHAs), we examined the extent to which certification findings were related to patient outcomes. In a previous study, we collected longitudinal patient data for a national sample of 42 HHAs and developed precise patient outcome measures. In this study, the outcome measures were compared to certification findings for the same HHAs and time period (1991-93). We found relatively little association between the two sets of measures. The findings indicate that the Medicare HHA survey process does not yet successfully incorporate patient outcomes.

Activities of Daily Living↗
PubMed1985

Health systems agency and state health planning and development agency reviews; certificate of need programs--PHS.

The Assistant Secretary for Health, with the approval of the Secretary of Health and Human Services, amends the regulations governing certificate of need reviews by State health planning and development agencies (State Agencies) and health systems agencies (HSAs). The amendments accomplish two tasks: (1) To implement amendments to the Public Health Service Act made by the Health Programs Extension Act of 1980 (Pub. L. 96-538) and the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35), and (2) to reduce Federal regulatory burdens. Under the provisions of Title XV of the Public Health Service Act, the planning agencies are required to administer certificate of need programs consistent with the Department's regulations, under which they review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. These regulations change the requirements for satisfactory certificate of need programs.

Certificate of Need↗
PubMed1982

Factors that may explain interstate differences in certificate-of-need decisions.

A major difficulty in conducting studies of the impact of certificate-of-need programs is in accounting for interstate differences in program characteristics. This paper addresses this problem by examining the empirical relationship between various characteristics of certificate-of-need programs and program decisions, measured in terms of the approvals of hospital capital projects. Aggregate data on capital expenditure approvals and net bed change approvals for 28 States are correlated with an index of each State's regulatory characteristics that was developed in an earlier study. In addition, a multivariate model of certificate-of-need approvals is estimated in which certain measures associated with the need for hospital capital in a State are introduced, along with the indices of regulatory characteristics, to explain interstate differences in regulatory characteristics, to explain interstate differences in program decisions. The results of this analysis indicate that although regulatory characteristics are significantly correlated with the relative number of new beds approved, they have little correlation with total capital expenditure approvals. Moreover, variables reflecting the need for new hospital capital in a State, such as past population growth and existing hospital capacity, appear to be more important than regulatory characteristics in explaining the relative amount of capital approvals.

Capital Expenditures↗