Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis
Abstract Background Valid cause of death data are essential for health policy formation. The quality of medical certification of cause of death (MCCOD) by physicians directly affects the utility of cause of death data for public policy and hospital management. Whilst training in correct certificatio...
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doaj-878b225f12e6499084a2bba0f6af14f92020-12-13T12:23:24ZengBMCBMC Medicine1741-70152020-12-0118112210.1186/s12916-020-01840-2Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysisU. S. H. Gamage0Pasyodun Koralage Buddhika Mahesh1Jesse Schnall2Lene Mikkelsen3John D. Hart4Hafiz Chowdhury5Hang Li6Deirdre McLaughlin7Alan D. Lopez8Melbourne School of Population and Global Health, University of MelbourneMelbourne School of Population and Global Health, University of MelbourneMelbourne School of Population and Global Health, University of MelbourneMelbourne School of Population and Global Health, University of MelbourneMelbourne School of Population and Global Health, University of MelbourneMelbourne School of Population and Global Health, University of MelbourneMelbourne School of Population and Global Health, University of MelbourneMelbourne School of Population and Global Health, University of MelbourneMelbourne School of Population and Global Health, University of MelbourneAbstract Background Valid cause of death data are essential for health policy formation. The quality of medical certification of cause of death (MCCOD) by physicians directly affects the utility of cause of death data for public policy and hospital management. Whilst training in correct certification has been provided for physicians and medical students, the impact of training is often unknown. This study was conducted to systematically review and meta-analyse the effectiveness of training interventions to improve the quality of MCCOD. Methods This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration ID: CRD42020172547) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. CENTRAL, Ovid MEDLINE and Ovid EMBASE databases were searched using pre-defined search strategies covering the eligibility criteria. Studies were selected using four screening questions using the Distiller-SR software. Risk of bias assessments were conducted with GRADE recommendations and ROBINS-I criteria for randomised and non-randomised interventions, respectively. Study selection, data extraction and bias assessments were performed independently by two reviewers with a third reviewer to resolve conflicts. Clinical, methodological and statistical heterogeneity assessments were conducted. Meta-analyses were performed with Review Manager 5.4 software using the ‘generic inverse variance method’ with risk difference as the pooled estimate. A ‘summary of findings’ table was prepared using the ‘GRADEproGDT’ online tool. Sensitivity analyses and narrative synthesis of the findings were also performed. Results After de-duplication, 616 articles were identified and 21 subsequently selected for synthesis of findings; four underwent meta-analysis. The meta-analyses indicated that selected training interventions significantly reduced error rates among participants, with pooled risk differences of 15–33%. Robustness was identified with the sensitivity analyses. The findings of the narrative synthesis were similarly suggestive of favourable outcomes for both physicians and medical trainees. Conclusions Training physicians in correct certification improves the accuracy and policy utility of cause of death data. Investment in MCCOD training activities should be considered as a key component of strategies to improve vital registration systems given the potential of such training to substantially improve the quality of cause of death data.https://doi.org/10.1186/s12916-020-01840-2Medical certification of cause of deathMedical educationIn-service medical trainingQuality of death certificationEffectiveness of trainingVital registration |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
U. S. H. Gamage Pasyodun Koralage Buddhika Mahesh Jesse Schnall Lene Mikkelsen John D. Hart Hafiz Chowdhury Hang Li Deirdre McLaughlin Alan D. Lopez |
spellingShingle |
U. S. H. Gamage Pasyodun Koralage Buddhika Mahesh Jesse Schnall Lene Mikkelsen John D. Hart Hafiz Chowdhury Hang Li Deirdre McLaughlin Alan D. Lopez Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis BMC Medicine Medical certification of cause of death Medical education In-service medical training Quality of death certification Effectiveness of training Vital registration |
author_facet |
U. S. H. Gamage Pasyodun Koralage Buddhika Mahesh Jesse Schnall Lene Mikkelsen John D. Hart Hafiz Chowdhury Hang Li Deirdre McLaughlin Alan D. Lopez |
author_sort |
U. S. H. Gamage |
title |
Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis |
title_short |
Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis |
title_full |
Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis |
title_fullStr |
Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis |
title_full_unstemmed |
Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis |
title_sort |
effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2020-12-01 |
description |
Abstract Background Valid cause of death data are essential for health policy formation. The quality of medical certification of cause of death (MCCOD) by physicians directly affects the utility of cause of death data for public policy and hospital management. Whilst training in correct certification has been provided for physicians and medical students, the impact of training is often unknown. This study was conducted to systematically review and meta-analyse the effectiveness of training interventions to improve the quality of MCCOD. Methods This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration ID: CRD42020172547) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. CENTRAL, Ovid MEDLINE and Ovid EMBASE databases were searched using pre-defined search strategies covering the eligibility criteria. Studies were selected using four screening questions using the Distiller-SR software. Risk of bias assessments were conducted with GRADE recommendations and ROBINS-I criteria for randomised and non-randomised interventions, respectively. Study selection, data extraction and bias assessments were performed independently by two reviewers with a third reviewer to resolve conflicts. Clinical, methodological and statistical heterogeneity assessments were conducted. Meta-analyses were performed with Review Manager 5.4 software using the ‘generic inverse variance method’ with risk difference as the pooled estimate. A ‘summary of findings’ table was prepared using the ‘GRADEproGDT’ online tool. Sensitivity analyses and narrative synthesis of the findings were also performed. Results After de-duplication, 616 articles were identified and 21 subsequently selected for synthesis of findings; four underwent meta-analysis. The meta-analyses indicated that selected training interventions significantly reduced error rates among participants, with pooled risk differences of 15–33%. Robustness was identified with the sensitivity analyses. The findings of the narrative synthesis were similarly suggestive of favourable outcomes for both physicians and medical trainees. Conclusions Training physicians in correct certification improves the accuracy and policy utility of cause of death data. Investment in MCCOD training activities should be considered as a key component of strategies to improve vital registration systems given the potential of such training to substantially improve the quality of cause of death data. |
topic |
Medical certification of cause of death Medical education In-service medical training Quality of death certification Effectiveness of training Vital registration |
url |
https://doi.org/10.1186/s12916-020-01840-2 |
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