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Data for the estimation of causes of death and the pattern of these deaths are scarce in sub-Sahara Africa (SSA) (4) unlike the developed countries where vital registration systems are well-developed and medical certifications of death are available (5).
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The BEDTAR pilot program assessed changes in the quality of certification of death's causes after a training session for the primary care physicians in the Tarragona's Area of Catalonia, in the Northeast of the Iberian Peninsula.
Key problems related to certification of death were identified.
This will help to improve the accuracy of causes of death from systems without medical certification of death [ 2].
Recording of pneumonia as a cause of death has been problematic in the UK until very recently, when specific guidance was issued for certification of death.
Of the 118 physicians that incorrectly completed the certification of death, 67 of them (56.8%) listed respiratory arrest, cardiac arrest or cardiopulmonary arrest as the immediate or the underlying cause of death.
In the event of death during the first 24 hours in the CMP unit, data were considered valid up to the earliest documented time of decision to withdraw all active treatment, certification of brainstem death, or certification of death, with agonal values valid only if charted.
We have endeavoured to capture the end of life contemporaneously and thus included not only the time of certification of death but also the time when death seemed apparent at the bedside in the absence of monitoring.
PMCT imaging was performed very soon after the subject's death; that is, the interval time between certification of death and PMCT acquisition ranged from 0.3 h to 10.1 h (median interval time: 1.8 h).
In the non-RA cohort, patients were followed for 3.2 years and the causes of death in this period were obtained from post-mortem reports and/or certification of death.
While mortality is the most comprehensive and homogeneous source of information on cancer in Spain, there is a clear under-registration when it comes to certification of death due to this tumour in Spain [ 8].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com