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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Birgitte Schmidt Astrup, University of Southern Denmark,
- Second opponent: Professor Elin Mortensen, UiT The Arctic University of Norway,
- Third member and chair of the evaluation committee: Lecturer Anton Baysa, University of Oslo
Chair of the Defence
Professor II Gunnar Einvik, University of Oslo
Principal Supervisor
Associate Professor Ulla Randen, University of Oslo
Summary
This doctoral thesis concerns public health and epidemiology.
Reliable cause of death statistics is essential for monitoring population health and planning health services. However, the accuracy of these statistics depends entirely on the quality of the underlying data.
For the statistics to be accurate, causes of death must be reported according to specific guidelines. Autopsy provides the most reliable determination of cause of death. Due to the low frequency of autopsies, death statistics rely largely on death certificates completed by physicians, which provide information on the presumed cause of death. When an autopsy is performed, the recorded cause of death is revised if the findings warrant it.
Parts of the underlying data for the cause of death statistics were examined using death certificates from nursing homes, autopsy reports, and data from the national Cause of Death Registry, with particular emphasis on whether the reported causes of death adhered to the guidelines. In addition, potential improvements in the quality of data on diabetes related deaths following the introduction of the electronic reporting system were assessed.
Key Findings:
- For death certificates errors in the reporting the cause of death were found in 34% of cases and varied depending on the type of physician completing the death certificate.
- For autopsy reports errors in the reporting of cause of death were found in 18% of the cases, near half of these led to an incorrect registered cause of death in the Cause of Death Registry. Long turnaround time for autopsies was also uncovered.
- Electronic reporting produced more specific diabetes codes, indicating improved data quality.
This thesis identifies quality gaps in Norway’s cause of death statistics and offers concrete suggestions for further research, as well as measures to strengthen quality assurance and improve the reliability of the statistics.
Additional information
Contact the research support staff.