Browsing by Subject "Cause of death"

Now showing 1 - 5 of 5
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    Evaluación de los cursos de certificación de las causas de la defunción para médicos en formación de la especialidad
    (Ministerio de Sanidad y Consumo, 2026-03-10) Cirera Suárez, Lluís; Maeso Martínez, Sergio; Fernández Somoano, Ana; Salmerón Martínez, Diego; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Medicina
    BACKGROUND // The causes of death are the pathologies that physicians fill on death certificates. The causes of death quality is a mandatory requirement for useful mortality statistics. To train physicians is essential for the correct fulfillment of death causes. The objective of this paper was to evaluate the efficacy of courses on causes of death certification to all physicians in specialty training. METHODS // A descriptive observational epidemiological study was conducted to evaluate the efficacy of medical death certification in eighteen in-person courses using a quasi-experimental pre- and posttest design aimed to all physicians during their specialty training in Spain. We assessed: legible handwriting; logical sequence; absence of abbreviations and acronyms; causal sequence, no added causes, no omitted causes; immediate, intermediate, fundamental causes, other conditions, and underlying cause. Correct toll was the achievement of 2/3 of the maximum score; and Suitable, the achievement of the correct score in logical and causal sequences, without added or omitted causes, and the three underlying causes of initial and final paired cases. We applied bivariate statistics to paired/unpaired indicators between individual/grouped pre-posttests, and multivariate statistics adjusting for evaluator and course. RESULTS // 96% of cases were included, and the 85% paired pre-posttests. The individual indicators grouped into Form, Concept, Result, and Total, improved significantly from the pretest. The matched and adjusted analysis showed a 26% to 80% increase of Suitable physicians in specialty training. CONCLUSIONS // The efficacy of the courses on medical certification is assessed. Systematic courses on certification of causes of death for all physicians in specialty training should be implemented.
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    Heterogeneidad en el perfil profesional y las actividades de los registros de mortalidad en España
    (Elsevier, 2022-05-28) Cirera, Lluís; Ballesta Ruiz, Mónica; Arana, Bárbara María; Chirlaque López, María Dolores; Grupo de Trabajo de Mortalidad de la Sociedad Española de Epidemiología; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Enfermería
    Objective: The mortality registries (MR) code death causes for the elaboration of the mortality statistics of the Spanish National Institute of Statistics (INE). Documentary research and medical training can improve this activity. Our objective was to analyse the professional profile and activities of the MR. Method: A survey was designed and distributed in February 2021. Professional profile, quality activities, medical training, and regular publications were the major topics. 16/18 MR participated. A cluster analysis was performed. Results: Eleven registries belong to Public Health. Five have an INE agreement, 39% provided training, and 56% made regular publications. Ten improved the causes of death, and 17% reviewed the automatic coding. The cluster analysis started from 5/16 groups of registries. Conclusions: The MR were heterogeneous in professionals, quality and publications. Homogeneity implies documentary search, a sole INE agreement, and providing systemic medical training.
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    Partial contributions and temporal trends of leading causes of death during the last four decades in Spain
    (Elsevier, 2020-12) Cirera, L; Márquez-Calderón, S; Saez, M; Salmerón, D; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Ciencias Sociosanitarias
    Objectives: The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975-2016 in Spain. Study design: A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975-2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods. Results: HIV/AIDS shaped the increasing trend period of infectious diseases in 1989-1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995-1999 and 1999-2016. Lung cancer fell gradually from 1994 in men (-0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980-2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes. Conclusions: Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.
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    Partial contributions and temporal trends of leading causes of death during the last four decades in Spain
    (Elsevier, 2020-12) Cirera, Lluís; Márquez Calderón, S.; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Sáez, Marc; Salmerón Martínez, Diego; Mortality working group of the Spanish Epidemiological Association; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Enfermería
    Objectives The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975–2016 in Spain. Study design A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975–2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods. Results HIV/AIDS shaped the increasing trend period of infectious diseases in 1989–1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995–1999 and 1999–2016. Lung cancer fell gradually from 1994 in men (−0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980–2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes. Conclusions Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.
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    Territorial gaps on quality of causes of death statistics over the last forty years in Spain
    (BMC, 2024-02-03) Cirera, L; Bañón, RM; Maeso, S; Molina, P; Salmerón, D; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Ciencias Sociosanitarias
    Background The quality of the statistics on causes of death (CoD) does not present consolidated indicators in literature further than the coding group of ill-defined conditions of the International Classification of Diseases. Our objective was to assess the territorial quality of CoD by reliability of the official mortality statistics in Spain over the years 1980–2019. Methods A descriptive epidemiological design of four decades (1980-, 1990-, 2000-, and 2010–2019) by region (18) and sex was implemented. The CoD cases, age-adjusted rates and ratios (to all-cause) were assigned by reliability to unspecific and ill-defined quality categories. The regional mortality rates were contrasted to the Spanish median by decade and sex by the Comparative Mortality Ratio (CMR) in a Bayesian perspective. Statistical significance was considered when the CMR did not contain the value 1 in the 95% credible intervals. Results Unspecific, ill-defined, and all-cause rates by region and sex decreased over 1980–2019, although they scored higher in men than in women. The ratio of ill-defined CoD decreased in both sexes over these decades, but was still prominent in 4 regions. CMR of ill-defined CoD in both sexes exceeded the Spanish median in 3 regions in all decades. In the last decade, women’s CMR significantly exceeded in 5 regions for ill-defined and in 6 regions for unspecific CoD, while men’s CMR exceeded in 4 and 2 of the 18 regions, respectively on quality categories. Conclusions The quality of mortality statistics of causes of death has increased over the 40 years in Spain in both sexes. Quality gaps still remain mostly in Southern regions. Authorities involved might consider to take action and upgrading regional and national death statistics, and developing a systematic medical post-grade training on death certification.