A composite metric for assessing data on mortality and causes of death: the vital statistics performance index
Open Access
- 14 May 2014
- journal article
- Published by Springer Science and Business Media LLC in Population Health Metrics
- Vol. 12 (1), 1-16
- https://doi.org/10.1186/1478-7954-12-14
Abstract
Timely and reliable data on causes of death are fundamental for informed decision-making in the health sector as well as public health research. An in-depth understanding of the quality of data from vital statistics (VS) is therefore indispensable for health policymakers and researchers. We propose a summary index to objectively measure the performance of VS systems in generating reliable mortality data and apply it to the comprehensive cause of death database assembled for the Global Burden of Disease (GBD) 2013 Study. We created a Vital Statistics Performance Index, a composite of six dimensions of VS strength, each assessed by a separate empirical indicator. The six dimensions include: quality of cause of death reporting, quality of age and sex reporting, internal consistency, completeness of death reporting, level of cause-specific detail, and data availability/timeliness. A simulation procedure was developed to combine indicators into a single index. This index was computed for all country-years of VS in the GBD 2013 cause of death database, yielding annual estimates of overall VS system performance for 148 countries or territories. The six dimensions impacted the accuracy of data to varying extents. VS performance declines more steeply with declining simulated completeness than for any other indicator. The amount of detail in the cause list reported has a concave relationship with overall data accuracy, but is an important driver of observed VS performance. Indicators of cause of death data quality and age/sex reporting have more linear relationships with simulated VS performance, but poor cause of death reporting influences observed VS performance more strongly. VS performance is steadily improving at an average rate of 2.10% per year among the 148 countries that have available data, but only 19.0% of global deaths post-2000 occurred in countries with well-performing VS systems. Objective and comparable information about the performance of VS systems and the utility of the data that they report will help to focus efforts to strengthen VS systems. Countries and the global health community alike need better intelligence about the accuracy of VS that are widely and often uncritically used in population health research and monitoring.Keywords
This publication has 22 references indexed in Scilit:
- Impact of a Hospital-Level Intervention to Reduce Heart Disease Overreporting on Leading Causes of DeathPreventing Chronic Disease, 2013
- Age-specific and sex-specific mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010The Lancet, 2012
- Algorithms for enhancing public health utility of national causes-of-death dataPopulation Health Metrics, 2010
- What Can We Conclude from Death Registration? Improved Methods for Evaluating CompletenessPLoS Medicine, 2010
- PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systemsHealth Policy and Planning, 2009
- Validation of cause-of-death statistics in urban ChinaInternational Journal of Epidemiology, 2007
- Potential misclassification of causes of death from COPDEuropean Respiratory Journal, 2006
- Data quality improvement in general practiceFamily Practice, 2006
- Quality of morbidity coding in general practice computerized medical records: a systematic reviewFamily Practice, 2004
- Cause of DeathJAMA, 1987