Drumond Jr, 19992424. Drumond Júnior M, Lira MMTA, Freitas M, Nitrini TMV, Shibao K. Avaliação da qualidade das informações de mortalidade por acidentes não especificados e eventos com intenção indeterminada. Rev Saude Publica 1999; 33(3):273-280.. |
Retrieval of information: field research of 550 deaths, excluding losses (3.3%), 297 (54%) unspecified accidents (X59/ICD-10) and 253 (46%) events of undetermined intent (Y10-Y34); - –
Sources: Forensic Medicine Institute (FMI) documents (police reports, accompanying the bodies, conclusions of autopsy reports, and hospital body referral records or the Coroner's Service).
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Classification after investigation X59: 66% (196) received better qualification; road traffic accidents-RTA (32.6%), falls (14.5%), homicides (7%) and suicides (2%); 13.1% (39) remained X59 e 20% (62) migrated to Y10-Y34;
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Reclassification X59: 49.5% (97) RTA, 21.9% (43) falls, 10.7% (21) homicides and 3.1% (6) suicides, among investigated with defined cause;
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Classification after investigation Y10-Y34: 33.6% (85) received better qualification; falls (10,6%), RTA (9,1%), homicides (7,5%) and suicides (2%);
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Reclassification Y10-Y34: 31.8% (27) falls, 27.1% (23) RTA, 22.4% (21) homicides and 5.9% (5) suicides, among investigated with defined cause;
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Increase of 7% de RTA (subinformation 6.6%), 13.4% falls (sub-information 12%); 2.2% suicides (sub-information 2%); 0.8% homicides (sub-information 1%).
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Municipality of S P. Data from 1996. |
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66.4% (168) of deaths remained with undetermined intent;
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Analyzing year 1996, when SIM shifted use from ICD-9 to ICD-10. Atypical transition period, which can influence coding.
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Mello-Jorge et al., 200244. Mello-Jorge MHP, Gotlieb SLD, Laurenti R. O sistema de informações sobre mortalidade: problemas e propostas para o seu enfrentamento, II - mortes por causas externas. Rev Brasileira de Epidemiologia 2002; 5(2):212-223.. |
Retrieval of information: field research of 156 deaths from two groups of undefined external causes: 83 totally undefined (Y10 to Y34/ ICD-10); and 73 incomplete diagnoses: unspecified RTA (V89); other unspecified accidents (falls-W19, deaths drownings-W74, accidents with fire and flames-X09, accidental exposure to factors-X59); unspecified suicides (X84); and unspecified homicides (Y09).
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Clarification of almost 79% of undefined causes, 82,3% among totally ill-defined, and 76.1% among incomplete diagnoses;
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Classification after investigation Y10-Y34: 82.3% (68) received better qualification; homicides (32.4%), traffic accident (27.9%), other accidents (13.2%) and suicides (5.9%); excluding losses (18.1%);
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Reclassification Y10-Y34: 39.3% (22) homicides, 33.9% (19) traffic accidents, 16.1% (9) other accidents, and 7.1% (4) suicides, among investigated with defined cause;
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Classification after investigation: unspecified RTA (V89): 76.5% (26) received better classification, 41.3% motor vehicle occupant, 20.6% motorcyclist, 11.8% pedestrian, and 2,9% cyclists;
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Reclassification V89: 53.9% (14) motor vehicle occupant, 26.9% (7) motorcyclist, 15.4% (4) pedestrian, and 3.9% (1) cyclists, among investigated with defined cause;
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Increase of 67% of traffic accidents (sub-information 40.1%), 66.7% other accidents (subinformation 40%), 23.5% suicides (sub-information 19%), 40.6% homicides (sub-information 28.9%).
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15 Municipalities (SP, SE and MT). Data from the 4th Quarter of 2000 |
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Matos et al., 20074040. Matos SG, Proietti FA, Barata RCB. Confiabilidade da informação sobre mortalidade por violência em Belo Horizonte, MG. Rev Saude Publica 2007; 41(1):76-84.. |
Retrieval of information: Field research of 445 deaths, excluding losses (22%); 70 unspecified accidents (X59/CID-10), e 375 events of undetermined intent (Y10-Y34;
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Classification after investigation X59: 82.9% (58) received better qualification, mainly accidents (68.6%), traffic accidents (34.3%), falls (18.6%), other specified accidents (12.8%), homicides (10%), and suicides (2.9%);
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Reclassification X59: 41.4% traffic accidents (24), 22.4% falls (13), 15.5% other specified accidents (9), 12.1% homicides (7), and 3.4% suicides (2), among investigated with defined cause;
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Classification after investigation Y10-Y34: 70.7% (265) received better qualification, mainly accidents (40.3%), homicides (20.8%), traffic accidents (19.5%), falls (12.8%), suicides (9.3%), and other accidents (6.4%);
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Reclassification Y10-Y34: 29.4% homicides (78), 26% traffic accidents (69), 18.1% falls (48), 13.2% suicides (35), and 9,1% Other accidents (24);
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Greatest increase in motor accidents (33.3%) and falls (28.4%), and also, 12.9% more suicides and 5.7% more homicides.
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Belo Horizonte-MG. Data from 1998 to 2000. |
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Cerqueira D, 20122222. Cerqueira D. Mortes violentas não esclarecidas e impunidade no Rio de Janeiro. Economia Aplicada 2012; 16(2):201-235.. |
Statistical model: mathematical modeling (econometric) of the characteristics associated with each violent incident defines the probabilistic prediction about the intention of the event among the causes of undetermined intent (Y10-Y34);
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Predictive capacity of the model was considerable, R2 of 82.3%. The model matched 97.1% and 99% of cases involving accidents and homicides, respectively, with much lower accuracy compared to suicides, 51.7%;
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From 2002 to 2006, the model predicted that the number of deaths from accidents would be about 3% higher than recorded. As of 2008, this difference would be about 6%. From 2000 to 2006, about 22% of homicides were “hidden”. From 2007, this difference increased substantially, reaching 62.5% in 2009.
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State of RJ. Data from 2000 to 2009. |
– The model was not very satisfactory for suicides, and excluded traffic accidents. |
Villela et al., 20124141. Villela LCM, Resende EM, Drumond EF, Ishitani LH, Carvalho GML. Utilização da imprensa escrita na qualificação das causas externas de morte. Rev Saude Publica 2012; 46(4):730-736.. |
Retrieval of information: field research of 153 death from external causes in three state newspapers of wide circulation and one national newspaper;
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Following investigation, 33% (7) remained as undetermined intents (Y10-Y34), and 12 were qualified as assaults (6) and traffic accidents (5), and the 16 unspecified traffic accidents were qualified;
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Among investigated deaths, traffic accidents hiked 14,3%, with an increase of 220% (n=22) in motor vehicles accidents and 100% motorcycles accidents (n=6), and 5.6% (n=76) homicides.
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Belo Horizonte-MG. Data from 2008. |
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Suicides are not generally published in newspapers;
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The media can overvalue aspects still unproven or not yet clarified;
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Incomplete information of victims in considerable part of the press reports.
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Global Road Safety Facility, 20144242. Global Road Safety Facility. Transport for health: the global burden of disease from motorized road transport. Seattle, Washington: IHME, The World Bank; 2014.. |
Statistical model: The Global Burden of Disease-GBD on motorized road transport is based on the 2010 GBD, using the Cause of Death Ensemble Modeling-CODEm to estimate mortality from traffic injuries worldwide. - The CODEm is an analytical tool used in the 2010 GBD and tests a wide range of possible statistical models of causes of death and creates a combined “set” of models that offers the best predictive performance. |
– It estimated for Brazil 43,985 deaths from traffic accidents (CI 35,301-52,857) in 2010, and reported as official data 36,499 deaths (they consider the WHO definition of death within 30 days). |
Brazil. Data from 2010. |
– Sophistication and complexity of a variety of statistical models. |