Seeking order amidst chaos : a systematic review of classification systems for causes of stillbirth and neonatal death, 2009-2014

dc.contributor.authorLeisher, Susannah Hopkins
dc.contributor.authorTeoh, Zheyi
dc.contributor.authorReinebrant, Hanna
dc.contributor.authorAllanson, Emma
dc.contributor.authorBlencowe, Hannah
dc.contributor.authorFrøen, 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.accessioned2016-11-22T07:21:47Z
dc.date.available2016-11-22T07:21:47Z
dc.date.issued2016-10-05
dc.descriptionAdditional file 1: PRISMA checklist.en_ZA
dc.descriptionAdditional file 2: Decision tree for inclusion/exclusion.en_ZA
dc.descriptionAdditional file 3: List of variables extracted.en_ZA
dc.descriptionAdditional file 4: Sensitivity of number of “widely used” systems to cut-offs for number of countries in which used and number of deaths classified.en_ZA
dc.descriptionAdditional file 5: All included publications with reason for inclusion and author intent.en_ZA
dc.descriptionAdditional file 6: Year of creation/modification of classification systems for causes of stillbirth and neonatal death developed or used between 2009 and 2014.en_ZA
dc.descriptionAdditional file 7: Countries in which more than one system was used to classify causes of stillbirths and/or neonatal deaths, 2009-2014.en_ZA
dc.descriptionAdditional file 8: National classification systems for causes of stillbirth and neonatal death in use 2009-2014.en_ZA
dc.descriptionAdditional file 9: Classification systems for causes of stillbirth and neonatal death used in highest-burden countries, 2009-2014.en_ZA
dc.descriptionAdditional file 10: Maximum percent of deaths classified as “other” and “unexplained” by classification systems according to type of death classified.en_ZA
dc.descriptionAdditional file 11: Kappa scores from reliability testing of classification systems for causes of stillbirth and neonatal death in use 2009-2014.en_ZA
dc.descriptionAdditional file 12: Selected shortcomings of existing systems and rationale for development of new systems/modification of existing systems.en_ZA
dc.description.abstractBACKGROUND : Each year, about 5.3 million babies die in the perinatal period. Understanding of causes of death is critical for prevention, yet there is no globally acceptable classification system. Instead, many disparate systems have been developed and used. We aimed to identify all systems used or created between 2009 and 2014, with their key features, including extent of alignment with the International Classification of Diseases (ICD) and variation in features by region, to inform the World Health Organization’s development of a new global approach to classifying perinatal deaths. METHODS : A systematic literature review (CINAHL, EMBASE, Medline, Global Health, and PubMed) identified published and unpublished studies and national reports describing new classification systems or modifications of existing systems for causes of perinatal death, or that used or tested such systems, between 2009 and 2014. Studies reporting ICD use only were excluded. Data were independently double-extracted (except from non-English publications). Subgroup analyses explored variation by extent and region. RESULTS : Eighty-one systems were identified as new, modifications of existing systems, or having been used between 2009 and 2014, with an average of ten systems created/modified each year. Systems had widely varying characteristics: (i) comprehensiveness (40 systems classified both stillbirths and neonatal deaths); (ii) extent of use (systems were created in 28 countries and used in 40; 17 were created for national use; 27 were widely used); (iii) accessibility (three systems available in e-format); (iv) underlying cause of death (64 systems required a single cause of death); (v) reliability (10 systems tested for reliability, with overall Kappa scores ranging from .35–.93); and (vi) ICD alignment (17 systems used ICD codes). Regional databases were not searched, so system numbers may be underestimated. Some non-differential misclassification of systems was possible. CONCLUSIONS : The plethora of systems in use, and continuing system development, hamper international efforts to improve understanding of causes of death. Recognition of the features of currently used systems, combined with a better understanding of the drivers of continued system creation, may help the development of a truly effective global system.en_ZA
dc.description.departmentObstetrics and Gynaecologyen_ZA
dc.description.librarianam2016en_ZA
dc.description.sponsorshipThe Mater Research Institute, University of Queensland, Australia, funded VF, and partially funded HR, AW, and SHL, and TZ as part of the University of Queensland undergraduate student scholarship, 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, Gülmezoglu, AM, Heazell, AEP, Korteweg, F, Lawn, J, McClure, EM, Pattinson, R, Smith, GCS, Tunçalp, O, Wojcieszek, AM & Flenady, V 2016, 'Seeking order amidst chaos: a systematic review of classification systems for causes of stillbirth and neonatal death, 2009-2014', BMC Pregnancy and Childbirth, vol. 16, art. #295, pp. 1-17.en_ZA
dc.identifier.issn1471-2393
dc.identifier.other10.1186/s12884-016-1071-0
dc.identifier.urihttp://hdl.handle.net/2263/58234
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.subjectClassification systemen_ZA
dc.subjectClassificationen_ZA
dc.subjectCause of deathen_ZA
dc.subjectInternational classification of diseases (ICD)en_ZA
dc.titleSeeking order amidst chaos : a systematic review of classification systems for causes of stillbirth and neonatal death, 2009-2014en_ZA
dc.typeArticleen_ZA

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