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This study validates World Health Organization (WHO) mortality statistics by comparing autopsy data from Vienna hospitals. Findings show higher atherosclerosis rates and a greater percentage of coronary heart disease (CHD) with multicausal evaluation.
Area of Science:
- Medical Statistics
- Public Health
- Pathology
Background:
- World Health Organization (WHO) mortality statistics face global criticism due to limitations in the International Classification of Diseases (ICD) coding, monocausal evaluations, and data inhomogeneity.
- Despite these criticisms, WHO statistics remain the sole method for comparing mortality rates across different regions.
- The reliability of these statistics is often questioned due to incomplete verification through post-mortem examinations.
Purpose of the Study:
- To assess the reliability of WHO mortality statistics by conducting a comprehensive analysis of death cases in Vienna hospitals.
- To compare findings from a high-autopsy-rate study with official Austrian mortality data.
- To highlight the importance of multicausal evaluation and electronic data processing in mortality statistics.
Main Methods:
- Collected data from over 15,000 death cases (approximately 60% of total deaths) in 9 Vienna hospitals during 1976.
- Achieved an autopsy rate of approximately 70% for the studied cases.
- Utilized a computer system for data processing and analysis to manage the large dataset.
Main Results:
- The study found a higher overall rate of atherosclerosis compared to official Austrian statistics, attributed to multicausal evaluation.
- A significantly higher percentage of coronary heart disease (CHD) was identified in the Vienna study cohort.
- A lower percentage of cerebral atherosclerosis was observed compared to official figures when autopsies were performed.
Conclusions:
- Mortality statistics based on a high autopsy rate and multicausal evaluation, supported by electronic data processing, offer a more accurate representation of disease prevalence.
- The study underscores the limitations of monocausal evaluations and highlights the need for comprehensive data verification in mortality statistics.
- Findings suggest that official statistics may underestimate the prevalence of certain conditions like atherosclerosis and CHD.
Abstract:
WHO mortality statistics are subject to severe criticism all over the world due to the ICD code, the monocausal evaluation and th inhomogenity of data which are only partially verified by post mortem findings. Despite this fact WHO statistics are the only possibility to compare morality in different areas. In order to prove their reliability we have collected data of patients who have died in 9 Vienna hospitals. Our material consists of more than 15000 out of 25000 death cases in the year 1976. The autopsy rate was about 70%. To handle this amount of datas a computer system was used. In comparison with the official Austrian statistics our total atherosclerosis rate was higher due to the multicausal evaluation and the much higher percentage of CHD. Atherosclerosis of the brain was found in a lower percentage than officially mentioned when autopsy was performed. An example for single case studies is the myocardial infarction in a defined age group to support the importance of statistics based on a high rate of autopsies and the use of electronic data processing.