Nairn J R, Cobbin D M, Fett M J, Adena M A
Aust N Z J Med. 1985 Oct;15(5):609-16.
Accuracy and consistency of death certification and coding practices in Australia were examined in relation to a defined population of 552 young men who died aged 20 to 40 years. For each death a mock death certificate was prepared by a team of physicians using all available clinical, pathological, and coronial data. These certificates, and their International Classification of Diseases (ICD 8) codes derived by an Australian Bureau of Statistics (ABS) nosologist, were compared with the actual death registration papers and their ICD 8 codes. Data for deaths from malignant neoplasms were also compared with results of histopathological review. The mock death certificates were superior to the true death certificates in both completeness of content and accuracy of the recorded cause of death. The major source of discrepancies was unsatisfactory narrative on the original death certificates, the standard of which varied with Australian state and with cause of death. The cause of death coding by ABS was of high standard, but its coding practices generally identify only death certificates where content is inadequate for specific coding. Where the narrative is sufficiently specific to be coded there is no mechanism for checking the accuracy of the cause of death recorded. Suggestions are made for improving the narrative.
针对澳大利亚552名年龄在20至40岁之间死亡的年轻男性这一特定人群，研究了死亡证明和编码做法的准确性与一致性。对于每一例死亡，一组医生利用所有可得的临床、病理和死因裁判数据编制了一份模拟死亡证明。将这些证明及其由澳大利亚统计局（ABS）疾病分类学家得出的国际疾病分类（ICD - 8）编码，与实际死亡登记文件及其ICD - 8编码进行比较。恶性肿瘤死亡数据也与组织病理学审查结果进行了比较。模拟死亡证明在内容完整性和记录死因准确性方面均优于真实死亡证明。差异的主要来源是原始死亡证明上的叙述不令人满意，其标准因澳大利亚各州以及死因不同而有所差异。ABS的死因编码标准很高，但其编码做法通常仅识别那些内容不足以进行特定编码的死亡证明。当叙述足够具体可进行编码时，没有机制来检查所记录死因的准确性。文中针对改进叙述提出了建议。
