Page 15 - MALAYSIAN BURDEN OF DISEASE AND INJURY STUDY, 2015-2017

2.2.1 The number of deaths with missing age or gender were
Missing data extremely low. Missing values were assigned to the most
redistribution prevalent age group or gender for the cause of death. Gross
errors in the mortality data were also identified and corrected
similarly by carrying out age-specific diseases check and
gender-specific diseases check prior to redistribution.

2.2.2 The assigned cause of deaths may represent causes of death
Garbage codes that do not accurately present the underlying cause of death.
redistribution These inappropriate ICD codes for mortality, collectively
known as “garbage codes”, compromise the usefulness of
cause of death information from a policy perspective. These
causes of death coded were listed as garbage codes if they
represent;

Causes that are not underlying cause or unlikely as a cause
of death
Intermediate causes of death
Immediate causes of death
Ill-defined or unspecified cause of death

Taking into consideration that Malaysia uses 3-character
ICD-10 coding for causes of death and local practices of
cause of death assignment, the team of Burden of Disease
experts undertook to analyse the garbage codes listed by
World Health Organization and Global Burden of Disease
study. The ill-defined causes were then distributed either
within specific disease groups, specific cause categories or
all causes categories using Cause Specific Mortality Fractions
(CSMF) (Byass, 2016). CSMF was applied on the medically and
non-medically certified death with the derived from medical
records review and verbal autopsy methods respectively. The
redistribution was able to give more accurate estimations of
mortality numbers and significantly reduced the number of
ill-defined cause of deaths for all-cause redistribution. The
final ill-defined cause of deaths was than redistributed pro-
rata either to all disease categories with Group I and II, or to
Group III for ill-defined injury causes. The final redistribution
of the garbage codes using the CSMF is summarized in table
as follow:

Malaysian Burden Of Disease And Injury Study 2015-2017
CENTRE FOR BURDEN OF DISEASE RESEARCH, INSTITUTE FOR PUBLIC HEALTH 5