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Multinational Comparisons of Stroke Epidemiology: Evaluation of Case Ascertainment in the WHO MONICA Stroke Study

Published on Mar 1, 1995in Stroke6.058
· DOI :10.1161/01.STR.26.3.355
Kjell Asplund24
Estimated H-index: 24
,
Ruth Bonita51
Estimated H-index: 51
+ 6 AuthorsJaakko Tuomilehto185
Estimated H-index: 185
Abstract
Background and Purpose As part of the WHO MONICA Project (World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease), mortality and incidence rates of acute stroke in 14 centers covering 21 populations from 11 countries were compared. Methods In this report, coverage and quality of the MONICA stroke registers were evaluated on five key indicators using data submitted to the MONICA Data Center. Results A low ratio of MONICA stroke register to routine statistics of stroke mortality and a low proportion of nonfatal out-of-hospital events were the most common biases; they indicate that identifications of fatal cases and/or case finding of nonfatal events occurring outside the hospital were inadequate in many MONICA centers. In 10 populations, the data quality analyses suggested that clarification of possible biases would be needed before these populations can be included in a comparative study. Data from the remaining 11 populations meet the data quality standards for multinationa...
  • References (21)
  • Citations (139)
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References21
Newest
#1Mona Britton (KI: Karolinska Institutet)H-Index: 18
Abstract. It has been questioned whether routine autopsies are needed any longer for control and correction of causes of death, specially in clear-cut cases. This question was therefore studied in connection with deaths in a department of internal medicine. Among 400 consecutive deaths autopsy was performed in 383 (96%). Causes of death diagnosed before autopsy were compared with those established by the same clinicians after autopsy. As main cause of death the clinical diagnosis was thereby con...
212 CitationsSource
#1Kjell Asplund (Umeå University)H-Index: 61
#2Jaakko TuomilehtoH-Index: 185
Last. Hugh Tunstall-Pedoe Fesc (Ninewells Hospital)H-Index: 62
view all 5 authors...
. Stroke events are being registered in 27 of the MONICA collaborating centres. Coding of test cases has shown the greatest discrepancies in coding of the type of stroke (different pathoanatomical diagnoses) and of the diagnostic category (whether a definite stroke has occurred or not), 23 % and 14 % discrepancies respectively. A check for completeness of stroke registration at the Northern Sweden MONICA Center showed that more than 91 % of the events were retrieved by routine registration proce...
150 CitationsSource
#1Cinzia SartiH-Index: 4
#2Jaakko TuomilehtoH-Index: 185
Last. Jorma TorppaH-Index: 29
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Our aim was to describe the mortality and early case-fatality rates of stroke in three geographic areas of Finland during 1983 to 1986 by means of a community-based stroke register and to estimate the accuracy of registration of stroke deaths in the official statistics compared with the FINMONICA stroke register.Annual and average mortality and case-fatality rates of stroke were derived from data collected in the FINMONICA stroke register during 1983 to 1986. Age-specific and age-standardized ra...
25 CitationsSource
#1Per HarmsenH-Index: 7
#2A TsipogianniH-Index: 8
Last. Lars WilhelmsenH-Index: 91
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Stroke risk factors have been shown to change with time in several places; simultaneously, stroke incidence rates have increased in some and decreased in other places. In Goteborg, Sweden, cardiovascular epidemiological research has included stroke registration since 1971. From these data on stroke, incidence and fatality rates from a 17-year period are given.During the period 1971-1987 all cases of stroke occurring in people aged 15-65 years in the city of Goteborg were uniformly recorded, with...
104 CitationsSource
#1Jaakko TuomilehtoH-Index: 185
#2Cinzia SartiH-Index: 34
Last. Jorma TorppaH-Index: 29
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124 CitationsSource
#1Birgitta Stegmayr (Umeå University)H-Index: 56
#2Kjell Asplund (Umeå University)H-Index: 24
The validity of routine stroke data (official mortality statistics and hospital discharge registries) and a population-based MONICA stroke registry was assessed in a population of 309,806 25- to 74-year-old people in Sweden. The ''true'' number of strokes in the population was estimated by screening for non-stroke diagnoses in death certificates and hospital discharge records and by a period of intensified search for otherwise unrecognized non-hospitalized stroke cases. Applying strict stroke cr...
148 CitationsSource
In order to study the need for medical care among elderly stroke patients, a prospective registration of cerebrovascular diseases started on January 1, 1986 in Enkoping-Habo health service district, Sweden. This article reports the design of the stroke register and the registration procedures, the annual events of stroke, both first-ever and recurrent, during 1986 - 1988 and the fatality rate with special regard to the very old population. The annual incidence of first-ever stroke was 0.33/1,000...
24 CitationsSource
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#2David R. JacobsH-Index: 145
Last. Linda Goldman (University of Tsukuba)H-Index: 1
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#1Maurice GiroudH-Index: 51
#2Beuriat PH-Index: 6
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Since 1985 there has been a Stroke Registry in Dijon to record every stroke occurring in the population of a city of 140,000 inhabitants. The survey has been exhaustive and included the numerous sourc
85 CitationsSource
Cited By139
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#1Linxin Li (University of Oxford)H-Index: 15
#2Lucy E Binney (University of Oxford)H-Index: 4
Last. Peter M. Rothwell (University of Oxford)H-Index: 108
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IntroductionAdministrative hospital diagnostic coding data are increasingly being used in identifying incident and prevalent stroke cases, for outcome audit and for ‘big data’ research. Validity of...
1 CitationsSource
#1Massimiliano Orso (University of Perugia)H-Index: 8
#2Francesco Cozzolino (University of Perugia)H-Index: 7
Last. Iosief AbrahaH-Index: 21
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Background Validation of administrative databases for cerebrovascular diseases is crucial for epidemiological, outcome, and health services research. The aim of this study was to validate ICD-9 codes for hemorrhagic or ischemic stroke in administrative databases, to use them for a comprehensive assessment of the burden of disease in terms of major outcomes, such as mortality, hospital readmissions, and use of healthcare resources. Methods We considered the hospital discharge abstract database of...
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#1C. Warlow (Glas.: University of Glasgow)H-Index: 1
#2J. van GijnH-Index: 84
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#1Marzia Baldereschi (National Research Council)H-Index: 31
#2Daniela BalziH-Index: 1
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Background Informing health systems and monitoring hospital performances using administrative data sets, mainly hospital discharge data coded according to International-Classification-Diseases-9edition-Clinical-Modifiers (ICD9-CM), is now commonplace in several countries, but the reliability of diagnostic coding of acute ischemic stroke in the routine practice is uncertain. This study aimed at estimating accuracy of ICD9-CM codes for the identification of acute ischemic stroke and the use of thr...
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#2Athanasia PatousiH-Index: 4
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Background and Purpose— Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of first-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece. Methods— Adult patients with first-ever stroke were registered during a 24-month period (2010–2012) and followed up for 12 months. To compare our stroke incidence with that observe...
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#1Shoichiro SatoH-Index: 14
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Source
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We studied 521 patients with stroke aged 50 to 80 years, selected randomized. The greatest frequency have brain infarcts (186 men and 255 women), followed by brain haemorrhage - 83 patients (37 men and 46 women) and the subarachnoid hemorrhages are rare - 17 (6 men and 11 women). In all patients were examined somatic and neurological status and conducted CT scans of the brain, electrocardiography and biochemical blood tests. Among patients with ischemic strokes from the well-documented risk fact...