Beyond the underlying cause of death: an algorithm to study multi-morbidity at death

Grippo, Francesco; Frova, Luisa; Pappagallo, Marilena; Barbieri, Magali; Trias-Llimós, Sergi; Egidi, Viviana; Meslé, France; Désesquelles, Aline

doi:10.1186/s12963-024-00356-8

Population Health Metrics

Table 1 Output of the algorithm on four death certificates

From: Beyond the underlying cause of death: an algorithm to study multi-morbidity at death

Step	Example 1				Example 2				Example 3				Example 4
1 Initial step	PI.a	I469	Cardiac arrest, unspecified	i	PI.a	J960	Acute respiratory failure	i	PI.a	I469	Cardiac arrest, unspecified	i	PI.a	B485	Pneumocystosis	o
	PI.b	I489	Atrial fibrillation and atrial flutter, unspecified	o	PI.b	J189	Pneumonia, unspecified	o	PI.b	R64	Cachexia	i	PI.b	R75	Laboratory evidence of human immunodeficiency virus [HIV]	i
	PI.c	I219	Acute myocardial infarction, unspecified	o	PI.c	G309	Alzheimer disease, unspecified	o	PI.b	I489	Atrial fibrillation and atrial flutter, unspecified	o
	PII	E149	Unspecified diabetes mellitus: Without complications	a	PI.d	J449	Chronic obstructive pulmonary disease, unspecified	o	PI.c	E86	Volume depletion	o
	PII	E149	Unspecified diabetes mellitus: Without complications	a	PI.d	J449	Chronic obstructive pulmonary disease, unspecified	o	PII	F03	Unspecified dementia	a
2A Checking sequences (due to rules)	Rules found in Iris decision tables:				Rules found in Iris decision tables:				Rules found in Iris decision tables:				No change
	I489 is due to I219				J189 is due to G309				I489 is due to E86
	PI.a	I469	Cardiac arrest, unspecified	i	PI.a	J960	Acute respiratory failure	i	PI.a	I469	Cardiac arrest, unspecified	i
	PI.b	I489	Atrial fibrillation and atrial flutter, unspecified	p	PI.b	J189	Pneumonia, unspecified	p	PI.b	R64	Cachexia	i
	PI.c	I219	Acute myocardial infarction, unspecified	o	PI.c	G309	Alzheimer disease, unspecified	o	PI.b	I489	Atrial fibrillation and atrial flutter, unspecified	p
	PII	E149	Unspecified diabetes mellitus: Without complications	a	PI.d	J449	Chronic obstructive pulmonary disease, unspecified	o	PI.c	E86	Volume depletion	o
	PII	E149	Unspecified diabetes mellitus: Without complications	a	PI.d	J449	Chronic obstructive pulmonary disease, unspecified	o	PII	F03	Unspecified dementia	a
2B Checking obvious consequences	No change				No change				Rules found in Iris decision tables:				No change
									E86 is obvious consequence of F03
									PI.a	I469	Cardiac arrest, unspecified	i
									PI.b	R64	Cachexia	i
									PI.b	I489	Atrial fibrillation and atrial flutter, unspecified	p
									PI.c	E86	Volume depletion	p
									PII	F03	Unspecified dementia	o
3 Application of special instructions of the ICD	No change				Rules found in Iris decision tables:				No change				Rules found in Iris decision tables:
					J449 is modified by J189 and transormed into J440								R75 modifies B485 which is transformed into B206
					PI.a	J960	Acute respiratory failure	i					PI.a	B206	HIV disease resulting in Pneumocystis jirovecii pneumonia	o
					PI.b	J189	Pneumonia, unspecified	c					PI.b	R75	Laboratory evidence of human immunodeficiency virus [HIV]	i
					PI.c	G309	Alzheimer disease, unspecified	o
					PI.d	J440	Chronic obstructive pulmonary disease with acute lower respiratory infection	o

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