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Lars Age Johansson

Publications and source records attributed to Lars Age Johansson.

6 recordsLinked to original sources
PubMed2005

Methodology of studies evaluating death certificate accuracy were flawed.

BACKGROUND AND OBJECTIVE: Statistics on causes of death are important for epidemiologic research. Studies that evaluate the source data often give conflicting results, which raise questions about comparability and validity of methods. METHODS: For 44 recent evaluation studies we examined the methods employed and assessed the reproducibility. RESULTS: Thirty studies stated who reviewed the source data. Six studies reported reliability tests. Twelve studies included all causes of death, but none specified criteria for identifying the underlying cause when several, etiologically independent conditions were present. We assessed these as not reproducible. Of 32 studies that focussed on a specific condition, 21 provided diagnostic criteria such that the verification of the focal diagnosis is reproducible. Of 16 that discussed the difference between dying "with" and "from" a condition, eight described how competing causes had been handled. For these eight, the selection of a principal cause is reproducible, but in three the selection strategy conflicts with the international instructions issued by the World Health Organization. CONCLUSION: Methods and criteria are often insufficiently described. When described, they sometimes disagree with the international standard. Explicit descriptions of methods and criteria would contribute to methodologic improvement and would allow readers to assess the generalizability of the conclusions.

Cause of Death↗
PubMed2005

An international comparison study indicated physicians' habits in reporting diabetes in part I of death certificate affected reported national diabetes mortality.

BACKGROUND AND OBJECTIVE: Physicians may find it confusing to decide whether to report diagnoses in part I or part II of the death certificate. The aim of this study was to contrast differences in diabetes mortality through a comparison of physicians' habits in reporting diabetes in part I of death certification among Taiwan, Australia, and Sweden. METHODS: A cross-sectional, intercountry comparison study. We calculated the proportion of deaths with mention of diabetes in which diabetes was reported in part I of the death certificate and the proportion of deaths with mention of diabetes in which diabetes was selected as underlying cause of death. RESULTS: We found that half of the differences in reported diabetes mortality among Taiwan, Australia, and Sweden were due to differences in reporting deaths with mention of diabetes anywhere on the certificate, and half due to differences in proportion of deaths with mention of diabetes in which diabetes was reported in part I of the death certificate. CONCLUSION: Differences in the reporting of diabetes in part I of the death certificate among physicians in Taiwan, Australia, and Sweden was one of the factors that affected differing reported diabetes mortality in Taiwan, Australia, and Sweden.

Aged↗
PubMed2002

Comparing hospital discharge records with death certificates: can the differences be explained?

STUDY OBJECTIVE: The quality of mortality statistics is important for epidemiological research. Considerable discrepancies have been reported between death certificates and corresponding hospital discharge records. This study examines whether differences between the death certificate's underlying cause of death and the main condition from the final hospital discharge record can be explained by differences in ICD selection procedures. The authors also discuss the implications of unexplained differences for mortality data quality. DESIGN: Using ACME, a standard software for the selection of underlying cause of death, the compatibility between the underlying cause of death and the final main condition was examined. The study also investigates whether data available in the hospital discharge record, but not reported on the death certificate, influence the selection of the underlying cause of death. SETTING: Swedish death certificates for 1995 were linked to the national hospital discharge register. The resulting database comprised 69 818 people who had been hospitalised during their final year of life. MAIN RESULTS: The underlying cause of death and the main condition differed at Basic Tabulation List level in 54% of the deaths. One third of the differences could not be explained by ICD selection procedures. Adding hospital discharge data changed the underlying cause in 11% of deaths. For some causes of death, including medical misadventures and accidental falls, the effect was substantial. CONCLUSION: Most differences between underlying cause of death and final main condition can be explained by differences in ICD selection procedures. Further research is needed to investigate whether unexplained differences indicate lower data quality.

Adolescent↗