COMPARATIVE-EVALUATION OF UNDERLYING CAUSES OF DEATH PROCESSED BY THEAUTOMATED CLASSIFICATION OF MEDICAL ENTITIES AND THE UNDERLYING CAUSEOF DEATH SELECTION SYSTEMS

Introduction The correct identification of the underlying cause of dea th and its precise assignment to a code from the International Classif ication of Diseases are important issues to achieve accurate and unive rsally comparable mortality statistics These factors, among other ones , led to the development of computer software programs in order to aut omatically identify the underlying cause of death. Objective This work was conceived to compare the underlying causes of death processed res pectively by the Automated Classification of Medical Entities (ACME) a nd the ''Sistema de Selecao de Causa Basica de Morte'' (SCB) programs. Material and Method The comparative evaluation of the underlying caus es of death processed respectively by ACME and SCB systems was perform ed using the input data file for the ACME system that included deaths which occurred in the State of S. Paulo from June to December 1993, to talling 129,104 records of the corresponding death certificates. The d ifferences between underlying causes selected by ACME and SCB systems verified in the month of June, when considered as SCB errors, were use d to correct and improve SCB processing logic and its decision tables. Results The processing of the underlying causes of death by the ACME and SCB systems resulted in 3,278 differences, that were analysed and ascribed to lack of answer to dialogue boxes during processing, to dea ths due to human immunodeficiency virus [HIV] disease for which there was no specific provision in any of the systems, to coding and/or keyi ng errors and to actual problems. The detailed analysis of these latte r disclosed that the majority of the underlying causes of death proces sed by the SCB system were correct and that different interpretations were given to the mortality coding rules by each system. that some par ticular problems could not be explained with the available documentati on and that a smaller proportion of problems were identified as SCB er rors. Conclusion These results, disclosing a very low and insignifican t number of actual problems, guarantees the use of the version of the SCB system for the Ninth Revision of the International Classification of Diseases and assures the continuity of the work which is being unde rtaken for the Tenth Revision version.