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Table 1 Summary of how alignment was assessed

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

 

Characteristics

Weight

Variables used to assess alignment

Aligned if

Judgment of variable accuracy as a measure of alignment

 

Structural characteristics

    

1

A global system must use rules to ensure valid assignment of cause of death categories

.98

Rules available?

Yes

Strong

2

A global system must be able to work with all levels of data (from both low-income and high-income countries), including minimal levels

.98

 

Yes for all three variables

 
   

Used in both HIC and LMIC?

 

Strong

   

Used with verbal autopsy?

 

Strong

   

Used in >1 LMIC?

 

Weak

3

A global system must ensure cause of death categories are relevant in all settings

.96

Used in both HIC and LMIC?

Yes

Weak

4

A global system must require associated factors to be recorded and clearly distinguished from causes of death

.94

 

Yes for both variables below

 
   

Associated factors included?

 

Strong

   

Distinguishes associated factors from causes?

 

Strong

5

A global system must distinguish between antepartum and intrapartum conditions

.90

Distinguishes IP from AP?

Yes

Strong

6

A global system should record the level of data available to assign the cause of death (e.g. verbal autopsy only, placental histology, autopsy, etc.)

.86

Records type of data used?

Yes

Strong

7

A global system must have multiple levels of causes of death, with a small number of main categories

.82

 

As below

 
   

Number of causes

≤10

Strong

   

Number of levels

2+

Strong

8

A global system must include a sufficiently comprehensive list of categories to result in a low proportion of deaths classified as “other”

.80

% “other”

Max <20 %

Weak

 

Functional characteristics

    

9

A global system must be easy to use, and produce data that are easily understood and valued by users

1

 

As below

 
   

# deaths classified/# countries of use

500+ cases and/or 2+ countries

Weak

   

Definitions available?

Yes

Weak

   

Rules available?

Yes

Weak

   

National?

Yes

Weak

10

A global system must have clear guidelines for use and definitions for all terms used

1

 

Yes for both variables below

 
   

Definitions available?

 

Strong

   

Rules available?

 

Strong

11

A global system must produce data that can be used to inform strategies to prevent perinatal deaths

.96

 

As below

 
   

IP vs AP?

Yes

Weak

   

% “other”

Max <20 %

Weak

   

National?

Yes

Weak

12

A global system must require neonatal deaths to be clearly distinguished from stillbirths

.94

 

Yes for both variables below

 
   

Distinguishes SB and NND?

 

Strong

   

Separate categories for SB and NND?

 

Strong

13

A global system must have high inter- and intra-rater reliability

.94

Reliability testing?

Yes; min ≥0.60

Strong

14

A global system must be available in different formats including inexpensive ehealth and mhealth options, and in multiple languages

.92

 

Yes for both variables below

 
   

E-format?

 

Strong

   

>1 language?

 

Weak

15

A global system must allow easy access to the data by the end-users

.92

Accessible data?

Yes

Weak

16

A global system must incorporate both stillbirths and neonatal deaths

.86

Both SB and NND?

Yes

Strong

17

A global system must require the single most important factor leading to the death to be recorded

.86

 

As below

 
   

Hierarchical?

No or partially

Weak

   

Only 1 cause allowed?

Yes

Strong

   

Includes FGR/IUGR/SGA?

No

Strong