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Table 1 Selected characteristics of classification systems for causes of stillbirth and neonatal death, 2009–2014

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

Characteristic All systems, n (%) Systems used in HIC only, n (%) Systems used in LMIC only, n (%)
For systems including any type of death (SB, NND, or both) 81 36 32
 Type of system
  New 14 (17) 6 (17) 4 (13)
  Modified 59 (73) 28 (78) 23 (72)
  Unknown 8 (10) 2 (6) 5 (16)
 Uses ICD codes
  Yes 17 (21) 3 (8) 8 (25)
  No 62 (77) 33 (92) 23 (72)
  Unclear 2 (3) 0 (0) 1 (3)
 Includes definitions for all causes of death
  Yes 23 (28) 9 (25) 11 (34)
  No 35 (43) 14 (39) 16 (50)
  Some causes only 23 (28) 13 (36) 5 (16)
 Includes a description of how COD are to be assigned
  Yes 33 (41) 16 (44) 9 (28)
  No 47 (58) 20 (56) 23 (72)
  Unclear 1 (1) 0 (0) 0 (0)
 Number of deaths classified using this system
  Not used 5 (6) 0 (0) 0 (0)
   < 500 44 (54) 17 (47) 26 (81)
  500-999 9 (11) 7 (19) 2 (6)
  1000+ 23 (28) 12 (33) 4 (13)
 Includes guidance on how potential users might access data from the system
  Yes 8 (10) 5 (14) 2 (6)
  No 66 (82) 24 (67) 30 (94)
  Unclear 7 (9) 7 (19) 0 (0)
 Available in e-format 3 (4) 2 (6) 1 (3)
 Available in more than 1 language 1 (1) 1 (3) 0 (0)
 Type of death classified
  Both SB and NND 40 (49) 20 (56) 14 (44)
  NND only 26 (32) 7 (19) 14 (44)
  SB only 15 (19) 9 (25) 4 (13)
Number of countries in which used
  0 5 (6) 0 (0) 0 (0)
  1 60 (74) 30 (83) 30 (94)
  2+ 13 (16) 6 (17) 2 (6)
  Used to report global data 3 (4) 0 (0) 0 (0)
 Tested for reliability
  Yes 10 (12) 4 (11) 3 (9)
  No 68 (84) 31 (86) 28 (88)
  Unclear 3 (4) 1 (3) 1 (3)
 Hierarchical
  Yes 18 (22) 4 (11) 10 (31)
  No 53 (65) 27 (75) 20 (63)
  Partially 7 (9) 4 (11) 0 (0)
  Unclear 3 (4) 1 (3) 2 (6)
 Requires that a single cause of death be recorded
  Yes 64 (79) 29 (81) 23 (72)
  No 12 (15) 6 (17) 5 (16)
  Unclear 5 (6) 1 (3) 4 (13)
 List of causes does not include FGR, IUGR or SGA
  Yes 65 (80) 27 (75) 28 (88)
  No 16 (20) 9 (25) 4 (13)
 Allows associated factors to be recorded
  Yes 23 (28) 13 (36) 6 (19)
  No 57 (70) 23 (64) 25 (78)
  Unclear 1 (1) 0 (0) 1 (3)
 Number of categories in top level
   ≤ 10 67 (83) 26 (72) 28 (88)
   > 10 14 (17) 10 (28) 4 (13)
 Number of levels
  > 1 44 (54) 21 (58) 17 (53)
  1 35 (43) 15 (42) 14 (44)
  Unclear 2 (3) 0 (0) 1 (3)
 Used with verbal autopsy 14 (17) 0 (0) 12 (38)
 Maximum percent of deaths classified as "other" using this system
   < 20 % 39 (48) 19 (53) 17 (53)
   ≥ 20 % 10 (12) 3 (8) 6 (19)
  No "other" category 27 (33) 12 (33) 9 (28)
  “Other” category but no data available 5 (6) 2 (6) 0 (0)
 Maximum percent of deaths classified as "unexplained" using this system
  < 20 % 25 (31) 12 (33) 13 (41)
   ≥ 20 % 38 (47) 18 (50) 14 (44)
  No "unexplained" category 11 (14) 4 (11) 4 (13)
  “Unexplained” category but no data available 7 (9) 2 (6) 1 (3)
 Allows the type of data available for assigning COD to be recorded 7 (9) 7 (19) 0 (0)
 Allows recording the level of certainty of the data 34 (42) 19 (53) 12 (38)
For systems including SB 55 29 18
 Requires recording whether the stillbirth was antenatal vs intrapartum
  Yes 16 (29) 8 (28) 5 (28)
  No 14 (26) 8 (28) 5 (28)
  Partially 25 (46) 13 (45) 8 (44)
For systems including both SB and NND 40 20 14
 Includes guidelines that require distinguishing between SB and NND
  Yes 13 (33) 6 (30) 5 (36)
  No 22 (55) 12 (60) 6 (43)
  Unclear 5 (13) 2 (10) 3 (21)
 Has separate categories for SB and NND
  Yes, all 9 (23) 2 (10) 6 (43)
  No 11 (28) 7 (35) 2 (14)
  Some 20 (50) 11 (55) 6 (43)
For systems allowing associated factors to be recorded 23 13 6
 Distinguishes associated factors from causes of death
  Yes 11 (48) 6 (46) 6 (67)
  No 10 (44) 7 (54) 1 (17)
  Unclear 9 (9) 0 (0) 1 (17)
  1. NOTE: Column percentages used. Due to rounding, totals may be slightly different from 100 %