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At least 811 records · Page 45Linked to original sources
PubMed2000

Errors in the certification of neonatal death.

OBJECTIVE: To examine the precision of the perinatal death certificate (PDC) and ascertain the possible sources of error in the certification of neonatal deaths. METHODS: The 'Main' and 'Other' causes of death recorded on the PDC were obtained from the Registry of Births, Deaths and Marriages and compared with those from a clinicopathological summary (CPS) completed after all pending laboratory results and/or autopsy information were available. RESULTS: There were 179 neonatal deaths during the 7 year period under review. The PDC and CPS main causes of death were concordant in 103 of 179 infants (58%) and discordant in the remaining 76 infants (42%). The PDC main cause of death was incorrectly classified in 61 of 76 infants (80%) with discordant findings and was incompletely classified in the remaining 15 infants (20%). The following discordancies were recorded for the 61 infants with an incorrect classification: (i) transposition of the 'Main' and 'Other' causes of death, resulting in a sequencing discordancy in 14 infants (23%); (ii) recording a non-pathological condition as the main cause of death in 40 infants (66%); and (iii) recording an incorrect pathological condition as the main cause of death in seven infants (11%). Eight of the 61 (13%) incorrect classifications and four of the 15 (27%) incomplete classifications were associated with laboratory and/or autopsy data being unavailable when the PDC was completed. CONCLUSIONS: The concordancy between the PDC and CPS would have increased from 58 to 91% if the 'Main' and 'Other' causes of death had been sequenced correctly, if the main cause of death had been ascribed to a pathological disease rather than a non-pathological condition and if corrective information from pending laboratory tests and/or autopsy examination had been made available to the Registry of Births, Deaths and Marriages.

Cause of Death↗
PubMed2001

A study of perianesthesia nursing practice: the foundation for newly revised CPAN and CAPA certification examinations.

The CPAN and CAPA nursing certification programs, sponsored by ABPANC, are designed to promote and enhance the quality of care delivered to patients who have received anesthesia. This article describes ABPANC's most recent Role Delineation Study (RDS), also called the Study of Practice. The work of a think tank that convened to reconceptualize the organizing framework for the certification examination programs is described, including the results of an environmental analysis. A variety of methods were used to conduct the study. As a result of study findings, the CPAN and CAPA programs have been redesigned to focus on the physiological, behavioral and cognitive, safety, and advocacy needs of perianesthesia patients. Those needs and the knowledge base that is required of perianesthesia nurses to meet those needs are defined. The first CPAN and CAPA examinations using the new framework will be given November 3, 2001.

Certification↗
PubMed2006

[Results of the certification of vascular centers by the German Society for Vascular Surgery].

INTRODUCTION: Advances in conventional vascular surgery, endovascular procedures and conservative treatment require close interdisciplinary cooperation. The term Vascular Centre indicates to patients and referring doctors optimal professional and organisational competence. METHODS: 73 applications by vascular centres for certification were made between June 2002 and December 2005, of which after audit 54 were successful for three years, including one centre each in Austria and Switzerland. 13 centres were not accepted and six are still under consideration. This analysis is based on the data of 52 certified centres in the Federal Republic of Germany. RESULTS: A mean of 1149 patients were hospitalized in these centres per year (12 % emergency admissions) and 2159 patients per year were treated as outpatients, 60 % with arterial vascular disease. All centres have vascular surgery and radiology department, 10 of the 52 centres cooperate with specialists in private practice to provide an angiology service. A mean of 460 arterial vascular operations and 239 arterial interventional procedures were performed at each centre annually. In addition there were operations for varicose veins (n = 217), shunt operations (n = 58) and major amputations (n = 42). Inpatient or outpatient conservative treatment (for peripheral vascular disease, diabetic foot syndrome, phlebothrombosis or chronic venous insufficiency) was given to a mean of 338 patients annually. CONCLUSIONS: Certification of interdisciplinary vascular centres provides structural and medical data and the beginnings of comparing such centres. A future task will be standardization of documentation and continuing assessment of the quality of results.

Certification↗
PubMed2002

The impact of the variation in death certification and coding practices on trends in mortality from ischaemic heart disease.

This review examines the literature relating to the effect of death certification practices, coding and the terminology used by certifiers on trends in mortality from ischaemic heart disease (IHD). The review identifies factors that affect mortality trends in a number of countries and discusses methods for assessing the impact of these issues on trends in mortality from IHD. The review found that although the magnitude of the effects of the issues on trends in mortality from ischaemic heart disease varied among countries and sub-populations, miscertification and the resultant assignment of misleading ICD codes, particularly for ill-defined cardiovascular conditions, were important factors affecting the IHD mortality trends. In light of these findings, it is essential to monitor regularly the accuracy of death certificates for IHD and consider necessary adjustments in analysing mortality trends from IHD.

Australia↗
PubMedDate not supplied

Deoxynivalenol in wheat and maize flour reference materials. 2. Preparation and certification.

The preparation of four cereal reference materials (two wheat and two maize) and the certification of their 4-deoxynivalenol (DON) contents is described. The materials were prepared and certified within the BCR programme of the Commission of the European Community as part of a broad activity to improve accuracy and agreement of measurements of importance in food and agriculture. Reference material RM 379 was prepared from naturally contaminated wheat four blended with 'blank' material to achieve the desired DON content. The reference material RM 378 was prepared from naturally contaminated maize identified as containing approximately the desired DON content. Details are given of the milling, blending and packaging procedure, and the checks to ensure homogeneity and stability of the materials. The reference materials RM 396 and 377 were similarly prepared from the blank wheat and maize samples respectively. The certification exercise was carried out by five laboratories (with a further two to three laboratories providing supporting data) using a variety of extraction and clean-up procedures with either high performance liquid chromatography (HPLC) or gas chromatography (GC) as the determinative stages. Wheat RM 379 was certified as containing DON at a level of 673 +/- 21 micrograms/kg and wheat RM 396 as containing less than 50 micrograms/kg. Maize RM 378 was certified as containing DON at 425 +/- 38 micrograms/kg and maize RM 377 as containing less than 50 micrograms/kg. The materials are intended for the verification of methods used to determine DON in cereal samples.

Certification↗
PubMed2004

Certification and program regulations for inpatient services to youth with addiction: a state-level analysis.

Recent evidence has indicated that the prevalence of addiction in youth is far higher than previously expected. High demand for services to this population require attention to programs providing interventions, in particular to the regulations and structures that assure youth receive quality services. Thus, the current research examines state-level certification and program requirements for inpatient youth facilities. Current data (from August 2002 through July 2003) on state-level regulations was collected from a variety of sources. Wherever possible, confirmation was sought from multiple sources. Multiple authors interpreted information. Youth with addictions are currently being treated across a wide variety of governmental agencies. Level of detail and clarity of information varied widely, as did distinctness of youth requirements from adult ones. Adequate regulatory attention was evident in a minority of states, while a handful of states did little or nothing to distinguish youth from adult services. While it is undoubtedly the case that providers within each state offer outstanding services, there is often little or no available protection for these youth through governmental regulations. Attention is needed in almost all states to providing additional regulations and program requirements that assure youth consistency in service quality. Recommendations are made for standards of certification requirements.

Accreditation↗
PubMed1992

Developing a certificate course for hospice nurses: a Delphi survey of subject areas.

A Delphi survey of 16 national experts in hospice nursing was conducted to address which subject areas were the most important to include in a certification course for hospice nurses. The three-round survey elicited 70 subject areas which were ranked in order of importance according to the group opinion of the panel of experts. The means, average deviations, standard deviations, and variances for each rank were calculated. The panel showed a high degree of consensus and there was little change in ranking after the second round. The survey produced results that should be of interest to organizations concerned with developing certification courses and examination procedures for hospice nurses.

Adult↗
PubMed1992

Organizational factors to consider when developing a certification program for hospice nurses: a Delphi survey.

A Delphi survey of 16 national experts in hospice nursing was conducted to address the question of which organizational factors should be considered when developing a certification program for hospice nurses. The three-round survey elicited many factors to consider which were arranged by category and ranked in order of importance according to the group opinion of the panel. The means, average deviations, standard deviations, and variances for each factor were calculated. The panel showed a high degree of consensus and there was little change in ranking after the second round. The survey produced results that should be of interest to organizations concerned with developing a certification program for hospice nurses.

Certification↗
PubMedDate not supplied

Assessment of nationally registered emergency medical technician certification training in the United States: the LEADS Project. Longitudinal Emergency Medical Technician Attributes Demo-graphic Study.

OBJECTIVES: To describe the adequacy and characteristics of emergency medical services education as assessed by a population-based sample of emergency medical technician (EMT)-basics and EMT-paramedics from the National Registry of Emergency Medical Technicians. METHODS: Stratified random samples of EMT-basics and EMT-paramedics from the National Registry of Emergency Medical Technicians were mailed a 46-item demographic survey and a 16-question education survey in 1999. RESULTS: Overall, EMT-basics and EMT-paramedics reported that course cost and distance to the course were not barriers. The majority of EMT-basic and EMT-paramedic respondents rated their course instructors and course materials as excellent or very good. EMT-basic and EMT-paramedic respondents felt that they were very well prepared from their training in the areas of trauma assessment (63% and 72%), medical assessment (59% and 65%), cardiac arrest management (64% and 76%), and airway management (69% and 77%), respectively. However, EMT-basic and EMT-paramedic respondents were less likely to feel very well prepared regarding childbirth (29% and 44%) and pediatric patient management (36% and 38%). Overall, EMT-paramedics were more likely to report being very well prepared for clinical activities and tasks from their training compared with EMT-basics. CONCLUSIONS: These findings suggest that EMT-basics and EMT-paramedics were satisfied and felt well prepared by their certification courses. Opportunities to improve certification training exist, particularly related to childbirth and pediatric patient management.

Adolescent↗
PubMed1993

European study of the certification and coding of causes of death of six clinical case histories of diabetic patients. EURODIAB Subarea C Study Group.

This study was designed to investigate the large differences in diabetes mortality rates in Europe. In each of the participating countries (France, Germany, The Netherlands, Northern Ireland-UK, Republic of Ireland, Romania, Scotland-UK, Switzerland) a random sample of certifying physicians was asked to certify the causes of death of six case histories which described the deaths of diabetic patients; the responses from an average of 220 physicians per country were analysed. These registered causes were then coded nationally and the underlying cause was compared with that following a central recoding. Overall 28% of the physicians surveyed recorded diabetes on the death certificate as the underlying cause of death--France was 25% below this overall average and Germany 21% above. The national coding of diabetes as the underlying cause of death differed from the central recoding with a comparative undercoding of almost 40% in Romania, 30% in Northern Ireland and 25% in Switzerland; in contrast, there was an overcoding of diabetes by 80% in The Netherlands and 60% in the Republic of Ireland. After adjusting for central recoding, in part an adjustment for certification habits, the national coding from this simulation study was able to explain 35% of the variation in the diabetes mortality rates. With such differences in the coding of diabetes, the currently published mortality rates for diabetes are not directly comparable between European countries; some suggestions are made for the reduction of the intercountry differences in the collection and analysis of mortality data for diabetes.

Abstracting and Indexing↗
PubMed1991

Death certificate categorization of malignant pleural and peritoneal mesothelioma in a cohort of asbestos insulation workers.

Accuracy of diagnosis of malignant mesothelioma (pleural and peritoneal) was studied in a cohort of asbestos insulation workers in the United States and Canada. Initial clinical diagnosis, clinical diagnosis at death and death certificate diagnosis were compared with the diagnosis of malignant mesothelioma ascertained by full data review at the Division of Environmental and Occupational Medicine, Mount Sinai Medical Center, New York ('best evidence'). In both groups the death certificate diagnosis was somewhat less frequently accurate than clinical diagnosis at death. Knowledge of the patients' occupational history by the attending physician and its relation to accuracy of diagnosis of malignant mesothelioma is considered.

Asbestos↗
PubMed1998

Validation of cause-of-death certification for outpatient cancers: the contrasting cases of melanoma and mycosis fungoides.

The reported incidence of cancers typically diagnosed in the outpatient setting may underestimate their true frequency, but the validity of mortality estimates from many of these causes has not been studied in detail. The authors sought to evaluate the validity of mortality estimation from death certificates for two such cancers, melanoma and mycosis fungoides (a cutaneous lymphoma), using routinely collected cancer registry data for 1973-1994 from the Surveillance, Epidemiology, and End Results program. Their method estimates that 93% of the deaths attributable to melanoma were certified as due to melanoma but that only 60% of the deaths attributable to mycosis fungoides were so certified. Evaluation of the accuracy of cause-of-death certification in this manner is helpful in the interpretation of mortality statistics.

Death Certificates↗
PubMed1979

Leukemia among Nebraska farmers: a death certificate study.

The risk of leukemia among farmers was studied using records of death certificates from Nebraska, 1957--1974. Comparison of occupation, as recorded on the death certificate, for 1084 leukemia deaths and 2168 deaths from other causes, matched for age at death, year of death, county of residence, race, and sex, revealed an elevated risk of leukemia among farmers (odds ratio = 1.25). The risk was greatest among farmers born after 1900 and dying before age 66 (odds ratio = 1.83). Stratification by county of residence showed a significantly elevated risk for farmers from heavy corn producing counties.

Adult↗
PubMed1992

Cancer identification using a tumor registry versus death certificates in occupational cohort studies in the United States.

Studies of cancer incidences among occupational cohorts are rarely performed in the United States because of incomplete registration and a limited time period available for follow-up. This study used data from concurrent studies of cancer mortality and incidence among a cohort of 4,528 fire fighters and police officers employed by the cities of Seattle and Tacoma, Washington, between 1944 and 1979 to examine the relative advantages of tumor registry and death certificate information. As expected, an increased ability to study relatively common cancers with low fatality rates was demonstrated using incidence data. The most dramatic example was seen for bladder cancer. Twenty-four bladder cancers had been diagnosed among the study cohort between 1974 and 1989, whereas only two deaths were attributed to this malignancy. The standardized incidence ratio for bladder cancer was 1.05 (95% confidence interval 0.67-1.55), whereas the corresponding standardized mortality ratio was 0.46 (95% confidence interval 0.05-1.65). The observed relative risk estimates for rapidly fatal cancers were similar using the two sources of information, and no increase in precision was observed. Of 142 persons in the registry area who died of cancer during the study period, 20 (14%) had a different site listed on the death certificate than was identified by the registry. Approximately 7% of the potential person-years of follow-up were lost due to migration out of the registry area; loss to follow-up was greater among older and short-term workers, but did not exceed 13% of the person-years. Population-based tumor registries can be a useful resource in the investigation of occupational cancer in the United States, especially for the study of cancers with high survival rates.

Adult↗
PubMedDate not supplied

The recording of demographic information on death certificates: a national survey of funeral directors.

OBJECTIVE: The authors sought to ascertain the methods used by funeral directors to determine the demographic information recorded on death certificates. METHODS: Standardized questionnaires were administered to funeral directors in five urban locations in the U.S. In addition, personnel on four Indian reservations were interviewed. Study sites were selected for diverse racial/ethnic populations and variability in recording practices; funeral homes were selected by stratified random sampling. RESULTS: Fifty-two percent of responding funeral directors reported receiving no formal training in death certification. Seventy-nine percent of respondents reported finding certain demographic items difficult to complete--26% first specified race as the problematic item, and 25% first specified education. The decedent's race was "sometimes" or "often" determined through personal knowledge of the family by 58% of respondents; 43% reported "sometimes" or "often" determining race by observation. Only three respondents reported that occupation was a problematic item. CONCLUSIONS: The authors recommend that the importance of demographic data and the instructions for data collection be clarified for funeral directors, that standard data collection worksheets be developed, and that training videos be developed.

Communication↗
PubMed1991

Conditions other than underlying cause of death listed on death certificates provide additional useful information for epidemiologic research.

Conditions other than underlying cause of death listed on death certificates may provide useful information for epidemiologic research. We explored this possibility for any mention of diabetes, renal diseases, and pneumonia-influenza-bronchitis on death certificates from the Chicago Western Electric Study. When we used any mention, sufficient numbers of deaths for analyses of risk factor associations with diabetes (N = 47), renal diseases (N = 25), and pneumonia-influenza-bronchitis (N = 59) were available; analyses for these risk factors were not possible using underlying cause of death alone (N = 3, 6, and 16, respectively). Using Cox regression, we observed positive associations of age, systolic blood pressure, serum cholesterol, body mass index, and cigarettes smoked per day with any mention of diabetes or renal disease. Age, systolic blood pressure, and cigarettes smoked per day were positively related to any mention of pneumonia-influenza-bronchitis; serum cholesterol and body mass index were inversely related to this endpoint. Whether we identified cardiovascular disease deaths using underlying cause, other mention, or any mention, the relations of established major risk factors with 25-year mortality were similar.

Adult↗
PubMed1992

Validity of demographic characteristics on the death certificate.

In a sample of the United States population from the Census Bureau's current Population Surveys, we compared demographic characteristics with those recorded on the death certificate for the 43,000 decedents in the samples followed from 1979 to 1985. Overall percentage agreements were: Sex 99.5, Race 99.4, Place of birth 99.4, Hispanic origin 98.7, and Veteran status 95.2. Relatively fewer American Indians and Asian/Pacific Islanders had death certificates that agreed with the baseline race (73.6% and 82.4%, respectively). The direction of disagreement suggests that current estimates of mortality rates for American Indians and Asian/Pacific Islanders are underestimated.

Bias↗
PubMed1979

An evaluation of income incentives and board-certification trends.

In this paper the author examines income differentials between board-certified and non-board-certified physicians to determine whether the trend toward board certification is consistent with economic incentives. Although simple income comparisons indicate substantial differentials by certification status, after adjustments are made for specialty-mix, age distribution, and hours worked, the remaining differential is small. However, results by specialty indicate that physicians are most likely to become certified in specialties with the largest income differentials.

Adult↗