BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

Chapter XVII
Changes in Assignments of Causes of Death
In this Investigation an important contribution
to knowledge of causes leading to
death in childhood was made by the additional
clinical and pathological data obtained
from hospital, clinical, and autopsy
records and from interviews in the homes of
deceased children. An analysis can now be
made in order to appraise the value of this
additional information for the correct assignment
of underlying causes and to formulate
practical recommendations for improving
mortality statistics, so they may serve as
the basis for planning health lprogranms and
evaluating progress as well as for research
into the etiology and epidemiology of discase.
The changes in assignments of causes of
death resulting from the additional information
obtained are made clear by a coinparison
of the final assignments with those
derived from data on the death certificates.
In eight of the projects (Chaco and San
Juan Provinces, Bolivia, Recife, Silo Paulo,
Sherbrooke, Chile, and Kingston-St. Andrew)
a copy of the death certificate was
attached to the completed questionnaire*
for each death, and in six others (Ribeirlio
PrHto, Cali, Cartagena, Medellin, Monterrcy,
and California) the data were transferrvd
from the certificate to a section (page
9) of the questionnaire. In the El Salvador
project such additional information was not
available for the complete series of deaths.
Therefore, the following account of changes
in assignments of underlying causes is given
for 14 projects.
*The questionnaire is reproduced in Appendix 1.
PROCEDURES FOR CLASSIFYING CAUSES OF DEATH
Procedures for the classification of underlying
causes as well as a.;sociated causes,
both those contributing to and those considered
consequences of the events leading
to death, were established in the initial
planning phase of the Investigation. A
Planning Conference specifically devoted
to problems of medical histories and certification
was held in October 1968 to lay
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lown these procedures. It was agreed that
complete and comparable information from
clinical histories, autopsy protocols, and
home interviews would have to be recorded
routinely on the questionna'res. Such conplete
information for time assignment of
multiple causes was considered essential for
the success of time Investigation, as well as
for future activities of the principal collab­