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At least 19 recordsLinked to original sources
PubMed1992

Death certification in Western Australia--classification of major errors in certificate completion.

We aimed to develop a method to classify those errors in the completion of death certificates arising from misunderstanding of the certification process. We reviewed 430 Western Australian death certificates registered in March 1990 using a method devised to differentiate between major and minor errors. Major errors were found in 16 per cent of certificates (95 per cent confidence interval 12 to 20 per cent). The error rate did not vary significantly between city and country areas, nor between teaching hospitals and other locations. The method was validated on a separate sample of 120 certificates. It has potential as a tool to monitor a critical but neglected step in the production of mortality statistics and to assess understanding of the process of death certification.

Death Certificates↗
PubMed1992

The proposed death certificate for South Africa. Part I. Death certificate description.

An altered 'Cause of Death' certificate is proposed. The major changes involve the use of the international format for certification of death and provision for collection of extra data, i.e. estimated age at death, sex, population group and, where relevant, the mass of an infant at birth. The new format will facilitate improved data collection and the certificate will stand international comparison.

Data Collection↗
PubMed1979

The Canadian certification examination in psychiatry. III. Towards better certification techniques.

Although there has been much criticism of specialty certification examinations there is general agreement that they are an important safeguard of competence in medical specialties where the consumer cannot judge this. The Canadian Royal College has made strenuous attempts to improve certification techniques but these have not been heretofore widely reported. This paper reports on the rationale for the replacement of the essay examination by multiple choice questionnaires, the problems associated with MCQ, and the efforts made to improve the fairness, validity and reliability of the clinical (oral) examination. These efforts have been in the areas of selection of examiners, training for examiners, standardization of marking and the conduct of the examination. A description is given of the conduct of the examination and what the examiners look for in the candidate's performance. The development and increasing importance of the In-Training Evaluation are discussed. The publication of A Resident's Guide to Psychiatric Education with multinational participation advances the possibility of future reciprocity in psychiatric examinations conducted in several English speaking countries.

Canada↗
PubMed1990

A study of selected death certificates from three Dublin teaching hospitals.

One hundred death certificates were compared over two time periods with the corresponding autopsy reports on the cases to ascertain if the causes of death from the two sources were similar. There was poor concordance between the two and it seems likely that reasons for requesting an autopsy did not extend to using the information to complete the death certificates. There were 55 errors on 45 certificates, and 19 certificates were so inaccurate as to warrant a change in the underlying cause of death. In only 10 cases was the certificate signed before the autopsy report was available; however, should clinicians have wished to add autopsy findings to the certificate later, there is no facility on the Irish death certificate to do so. A revision of the format of the certificate is recommended. An examination of death certificates from varied medical sources would be welcome to see if the serious errors identified in this study are more widespread.

Autopsy↗
PubMed1991

A minor office: the variable and socially constructed character of death certification in a Scottish city.

Those doctors in a Scottish city who had completed the most death certificates in 1985 were identified, interviewed about their certifying practices, and asked, for comparative purposes, to complete a series of dummy death certificates, based on case summaries. Analysis of the dummy certificates indicated substantial inter-practitioner variations in practice. From the interview data it is clear that the completion of death certificates is a very minor office: for most certifying doctors, death certification is an unsupervised, unreported, invisible, and unconsidered activity. It is argued that doctors who write large numbers of certificates conduct their certifications in Schutz's "world of routine activities" (Schutz 1970). It is this routinized orientation to certification that allows the practitioner to dwell within the "habitus" (Bourdieu 1977) of the medical collectivity but outside a normative order. Death certification may stand as an exemplar of a large number of medical activities, where wide and largely unacknowledged variations in practice occur with each practitioner investing his or her own practices with moral worth. Routinization ensures a moral order in the habitus, but not a normative order.

Death Certificates↗
PubMed1991

The accuracy of death certificates. Implications for health statistics.

The death certificate is an important source of data on disease incidence, prevalence and mortality. It should therefore be as accurate and complete as possible. Death certificates from 433 autopsied hospital patients were reviewed and matched against the results of post-mortem examinations. Significant discrepancies between the two documents were observed in 50% of patients. In 25%, the immediate cause of death was incorrectly stated on the certificate, having been assigned to a different organ system in the majority of those cases. In 33%, there was disagreement on major disease other than the immediate cause of death. In 9%, the death certificate was signed before the autopsy was performed. The extent of disagreement was largely independent of whether the certificate was signed before or after the autopsy. We conclude that: (1) there is a significant discrepancy between autopsy diagnoses and entries on death certificates; (2) disagreement is not due to unavailability of autopsy data at the time of completion of the certificate; (3) death certificates should be completed or amended utilizing data gained at autopsy.

Autopsy↗
PubMed1992

Death certification in Auckland.

AIMS: to investigate the reasons behind general practitioner referral of cases of natural death to the coroner, and also the understanding of general practitioners of the relevant legislation. METHODS: as cases of natural death were referred to the coroner over a seven month period, the deceased's general practitioner was contacted by telephone and questioned regarding his/her knowledge of the death and willingness to sign a cause of death certificate. Based upon this interview, cases were divided according to whether their general practitioner could have signed the death certificate or not. RESULTS: there were 314 cases where there was a contactable general practitioner. In 257 instances, the general practitioner would not have signed the death certificate: 183 found the death unexpected, and 74 had not seen the patient recently enough. In 57 instances the general practitioner would have signed the death certificate, but did not because: 23 were unaware of the death, 13 could not be contacted, 14 did sign a death certificate but this was rejected by the medical referee, and seven would have signed but did not for miscellaneous reasons. CONCLUSION: a disturbing finding was the general lack of understanding of certification legislation in particular the concept that the patient must have been seen in their last illness to be able to sign the death certificate. When signing death certificates, doctors should be thinking in terms of last illness rather than a vague period of time between two weeks and three months.

Cause of Death↗
PubMed1990

State boards of optometry requirements of CPR certification for optometric licensure.

Cardiopulmonary resuscitation (CPR) certification requirements for optometric licensure were obtained from 49 states, the District of Columbia and Puerto Rico. It was found that 17 percent of the states required CPR certification for optometric licensure while 11 percent required certification to maintain licensure. For initial Diagnostic Pharmaceutical Agents (DPA) licensing 44 percent of the boards required CPR certification while less than 25 percent required maintaining that certification to sustain DPA licensure. Of those states having Therapeutic Pharmaceutical Agents (TPA) legislation, 36 percent required CPR certification for initial licensure but only 8 percent of them required maintenance of certification for license renewal. Optometry can take the lead in health care by requiring CPR certification for all forms of licensure and license renewal.

Certification↗
PubMed1991

Certification and recertification.

The American Board of Psychiatry and Neurology issues certificates for psychiatrists in general psychiatry, child and adolescent psychiatry, and added qualification in geriatric psychiatry. It will issue a certificate in added qualification in clinical neurophysiology in 1992. An application for a certificate in added qualification in addiction psychiatry is currently under review by the American Board of Medical Specialties. The American Psychiatric Association has requested that the ABPN consider forensic psychiatry for an added qualification. All new subspecialty certificates will have a ten year time limit. Beginning on October 1, 1994, all certificates will be time-limited. Time-limited certificates will lead to the requirement for recertification. Current requirements for certification are reviewed and strategies for planing for recertification are discussed.

Adolescent Psychiatry↗