‘Inaccuracy’ in death certification – where are we now?

摘要: Background This review aims to document and analyse aspects of death certification that are relevant public health. Methods A literature on primarily used the computerized Index Medicus (1981 mid1995), concentrated completing certificates, accuracy, standards, education procedural requirements. Further sentinel publications pre-dating this were identified from main base. Results The uses mortality data, historical context for recording death, philosophy Underlying Cause Death its relationship 'the truth', extent impact 'inaccuracy', certificate certifier, possible ways forward discussed. It is argued question 'How inaccurate cause data?' harder answer than suggests. Deriving a useful estimate difficult because inter-study differences in (1) definition, measurement (how by whom?) practical importance error, standards used; (2) focus (e.g. or data), observing everyday practice simulation exercises, diagnostic and/or semantic issues. Conclusion traditional perspective improving quality has not worked. There need reorientated thinking rather just urging more education. Evidence-based educational interventions needed. flaws theoretical framework routine nature unavoidable, but require consideration. Certifiers feedback mechanisms, integral continuing assurance at all levels fostering an understanding construction data. Continued development should be core health medicine role.