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Using live clinical data such as the GPRD for epidemiological studies requires mass application of case identification criteria, rather than examining each case individually.
It is also helpful to make accessible a table of the medical OXMIS and Read codes used for diagnosis (or the mapping of these codes to specific ICD codes), so that others studying the disease can replicate case identification criteria.
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At the time when an audit system for maternal mortality and severe morbidities was introduced in this hospital, there was no internationally accepted standard definition and uniform case-identification criteria for severe maternal morbidity [ 14].
Nevertheless, routine implementation and wider application of this concept in reviewing clinical care has been limited due to the lack of a standard definition and uniform case-identification criteria.
Case-control studies require adequate case identification, eligibility criteria for equal access of cases and controls to screening, distinguishing symptomatic and diagnostic tests, and adjustments for self-selection bias [ 1].
The timing of suspected influenza cases generally paralleled that of confirmed cases except in Spain, where the number remained elevated for the duration of the study because of the boarder criteria for case identification.
Case identification was based on unambiguous histological criteria, and controls were also selected on the basis of strict criteria, such as normal findings on digital rectal examination and PSA in the normal range for age, taking into account the ethnic background of the population.
Wide discrepancies in case identification have been reported when different criteria are used [ 11- 13].
Considering the variation in case identifications even within each category of identification criteria it is difficult to make comparisons as well.
However, there is currently no standard definition of neonatal near miss or any internationally agreed identification criteria for neonatal near miss cases.
3 Diagnostic criteria used at the time for MOH case identification are unknown to the present authors.
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