Classification systems for causes of stillbirth and neonatal death, 2009–2014 : an assessment of alignment with characteristics for an effective global system

dc.contributor.authorLeisher, Susannah Hopkins
dc.contributor.authorTeoh, Zheyi
dc.contributor.authorReinebrant, Hanna
dc.contributor.authorAllanson, Emma
dc.contributor.authorBlencowe, Hannah
dc.contributor.authorErwich, Jan Jaap
dc.contributor.authorFroen, J. Frederik
dc.contributor.authorGardosi, Jason
dc.contributor.authorGordijn, Sanne
dc.contributor.authorGulmezoglu, A. Metin
dc.contributor.authorHeazell, Alexander E.P.
dc.contributor.authorKorteweg, Fleurisca
dc.contributor.authorLawn, Joy E.
dc.contributor.authorMcClure, Elizabeth M.
dc.contributor.authorPattinson, Robert Clive
dc.contributor.authorSmith, Gordon C.S.
dc.contributor.authorTuncalp, Ozge
dc.contributor.authorWojcieszek, Aleena M.
dc.contributor.authorFlenady, Vicki
dc.date.accessioned2016-10-14T11:22:18Z
dc.date.available2016-10-14T11:22:18Z
dc.date.issued2016-09-15
dc.descriptionAdditional file 1: 81 included systems and selected features.en_ZA
dc.descriptionAdditional file 2: Variables used to assess system alignment with expert-identified characteristics for an effective global classification system for causes of stillbirth and neonatal death.en_ZA
dc.descriptionAdditional file 3: Sensitivity analyses.en_ZA
dc.description.abstractBACKGROUND : To reduce the burden of 5.3 million stillbirths and neonatal deaths annually, an understanding of causes of deaths is critical. A systematic review identified 81 systems for classification of causes of stillbirth (SB) and neonatal death (NND) between 2009 and 2014. The large number of systems hampers efforts to understand and prevent these deaths. This study aimed to assess the alignment of current classification systems with expert-identified characteristics for a globally effective classification system. METHODS : Eighty-one classification systems were assessed for alignment with 17 characteristics previously identified through expert consensus as necessary for an effective global system. Data were extracted independently by two authors. Systems were assessed against each characteristic and weighted and unweighted scores assigned to each. Subgroup analyses were undertaken by system use, setting, type of death included and type of characteristic. RESULTS : None of the 81 systems were aligned with more than 9 of the 17 characteristics; most (82 %) were aligned with four or fewer. On average, systems were aligned with 19 % of characteristics. The most aligned system (Frøen 2009-Codac) still had an unweighted score of only 9/17. Alignment with individual characteristics ranged from 0 to 49 %. Alignment was somewhat higher for widely used as compared to less used systems (22 % v 17 %), systems used only in high income countries as compared to only in low and middle income countries (20 % vs 16 %), and systems including both SB and NND (23 %) as compared to NND-only (15 %) and SB-only systems (13 %). Alignment was higher with characteristics assessing structure (23 %) than function (15 %). CONCLUSIONS : There is an unmet need for a system exhibiting all the characteristics of a globally effective system as defined by experts in the use of systems, as none of the 81 contemporary classification systems assessed was highly aligned with these characteristics. A particular concern in terms of global effectiveness is the lack of alignment with “ease of use” among all systems, including even the most-aligned. A system which meets the needs of users would have the potential to become the first truly globally effective classification system.en_ZA
dc.description.departmentPaediatrics and Child Healthen_ZA
dc.description.librarianam2016en_ZA
dc.description.sponsorshipThe Mater Research Institute of the University of Queensland, Australia, provided partial funding for VF, HR, AW, TZ, and SHL to undertake this study.en_ZA
dc.description.urihttp://www.biomedcentral.com/bmcpregnancychildbirthen_ZA
dc.identifier.citationLeisher, SH, Teoh, Z, Reinebrant, H, Allanson, E, Blencowe, H, Erwich, JJ, Frøen, JF, Gardosi, J, Gordijn, S, Gulmezoglu, AM, Heazell, AEP, Korteweg, F, Lawn, J, McClure, EM, Pattinson, R, Smith, GCS, Tunçalp, O, Wojcieszek, AM & Flenady, V 2016, 'Classification systems for causes of stillbirth and neonatal death, 2009–2014 : an assessment of alignment with characteristics for an effective global system', BMC Pregnancy and Childbirth, vol. 16, art. #269, pp. 1-16.en_ZA
dc.identifier.issn1471-2393
dc.identifier.other10.1186/s12884-016-1040-7
dc.identifier.urihttp://hdl.handle.net/2263/57325
dc.language.isoenen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.en_ZA
dc.subjectStillbirthen_ZA
dc.subjectNeonatal deathen_ZA
dc.subjectPerinatal deathen_ZA
dc.subjectClassificationen_ZA
dc.subjectClassification systemen_ZA
dc.subjectCauseen_ZA
dc.titleClassification systems for causes of stillbirth and neonatal death, 2009–2014 : an assessment of alignment with characteristics for an effective global systemen_ZA
dc.typeArticleen_ZA

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