MONICA Manual, Part II, Section 1

	Annual Demographic and Mortality data ANNUAL POPULATION MORTALITY REPORTING FORM (ICD-10) Form: EA      Version: 2      1.12.98	FOR MDC USE ONLY Seq.no: Received:

Please print carefully or type the requested information. Please complete all blanks in accordance with the instructions provided. Complete one form for each MONICA Reporting Unit for each sex each year.

Instructions

The purpose of this form is to provide a convenient and common format for reporting annually the official statistics of the total number of deaths and the number of deaths from selected causes among residents of each official MONICA Reporting Unit. The numbers provided on this form are an essential component in the investigation of cardiovascular disease mortality trends.

This form is to be completed once each year and reported to the MONICA Data Centre (MDC), so that it is received there by 31 December each year.

The time period for which information is to be reported is the calendar year (1 January through 31 December) as stated on the form. The data provided are to be the best available estimates of the number of deaths occurring among MONICA Reporting Unit residents during this calendar year.

The information is to be provided separately for males and females for deaths of residents of each official MONICA Reporting Unit. See Part I, Appendix 2 for a list of these Reporting Units and code numbers.

This form is to be used for those death registration systems using the International Classification of Diseases 1993 Revision (ICD-10). If the source of information for the numbers of deaths reported here uses ICD-10 codes, then this form should be used. If the source uses the International Classification of Diseases 1975 Revision (ICD-9) then the ICD-9 form should be used. If the source uses the International Classification of Diseases 1965 Revision (ICD-8) then the ICD-8 form should be used.

This form is to be completed by the MCC Principal Investigator or by someone officially designated to perform this task.

General instructions for completing form

This form can be completed either by typewriter or by hand. For the table of mortality figures, a computer printout can also be pasted on the form, as described in more detail in the specific instructions. The recorded information should be examined carefully for both correctness and legibility. Further, since it may be necessary to photocopy the form, perhaps several times, as a routine part of processing and providing reserve copies it is essential that the recorded information be clear and dark. Hence, please use a dark ribbon if a typewriter is used or a dark ball-point pen if the form is completed by hand.

This form includes blank spaces where you are to record the requested information. None of these spaces should be left blank. If you have no information to provide for a specific item, then so indicate according to the instructions for that item.

If a mistake is made in entering information on an item other than the mortality table, please draw a single line through the erroneous entry and provide the correct information in the immediate neighbourhood. If an error is made in the mortality table, draw a single line through the erroneous entry and write and circle a capital letter in the cell of the erroneous entry. In the right side of the table, print or type and circle the same letter followed by the correct number. Use different letters for different corrections. If the number of corrections required has made the form difficult to read or perhaps confusing, please re-enter the information on a new copy and send this new copy of the form to the MDC. If this step is required, please check the final copy carefully to make sure that no new errors were made in the process of re-copying the numbers onto the new form.

A completed form with error corrections is enclosed at the end of the specific instructions.

Specific instructions for each item

These instructions should be followed carefully when completing the indicated version of the Annual Population Mortality Reporting Form (ICD-10). Please ensure that the instructions are for the version of the form being completed. Specific instructions are listed by item below:

Item 1

Print or type the official MONICA Collaborating Centre name and code number in the spaces provided. Use the name and code number as they appear in Part I, Appendix 2: MONICA Collaborating Centres and Reporting Units.

Item 2

Print or type the official MONICA Reporting Unit name and code number in the space provided. Use the name and code number as they appear in Part I, Appendix 2. Even if your centre has only one Reporting Unit, please enter the appropriate name and code number here. Do not leave this item blank. If your centre has more than one Reporting Unit, then complete one form for each sex for each Reporting Unit and record the appropriate name and code number for the Reporting Unit in this space.

Item 3

Print or type the calendar year (1 January through 31 December) for which data are being provided. Please contact the MDC for instructions and note in item 8 if the reporting period does not correspond to a calendar year as described above. Include all four digits of the year as described in the completed example form at the end of these instructions.

Item 4

Note that separate forms are to be completed for males and females. For each form print or type the appropriate number in the coding box to the right.

Print or type the official number of deaths among residents of the official MONICA Reporting Unit for each age group - ICD-10 code combination in the appropriate cell. Alternatively, paste a computer printout on top of the table on the form. Such a computer printout must have the title and the total columns included, and the age groups and the ICD-10 code categories must be in the same order as in the original form. However, it is not necessary to include the vertical and horizontal lines in the printout. An example of such a computer printout is given at the end of the instructions for the ICD-9 form.

Note: If you have decided to exclude some people living in the Reporting Unit area (e.g. those who are not citizens of the country) from the survey sample and event monitoring, such population groups are excluded from the MONICA study population. Hence, such people must not be counted here.

The ICD-10 categories for which data are to be reported: Specific instruction for completing each disease group are listed below. If data for some disease group are not available for your reporting unit, please print N.A. in the corresponding row of item 4 and explain in item 8 the reason for not being able provide the data.

If the MCC includes only ages 25-64 in the event registration activities, then it is not necessary to report these mortality statistics for the age groups 65-69 and 70-74. In such a case "NA" should appear in the respective columns of the "Total deaths" row of the table.

Item 5

This item was added as an attempt to help read hand-written entries that may appear elsewhere on this form. If you are entering data on this form by typewriter, leave this item blank. If you are completing the form by hand, please write, in your handwriting, each number above the digits as shown in the example below. Then compare the entries in the table and elsewhere on the form with those as written for this item and change those that may be confusing or unclear.

Item 6

Print or type the appropriate number in the box for the code number. If the source of the information is not the same as reported for the previous year, please indicate the reason for the change in Item 8.

Use codes as follows:

1. Local registry: use this code if the numbers of deaths by cause were obtained directly from a local registration system with the area covered by this system corresponding exactly with the area of the MONICA Reporting Unit.
2. Regional registry: use this code if the numbers of deaths by cause were obtained directly from a regional registration system which covers a broader area than the MONICA Reporting Unit area, but which does not cover the entire country. Clearly, if such a registry is used, the deaths occurring among residents of the MONICA Reporting Unit must be identifiable as having occurred in that Reporting Unit.
3. National registry: use this code if the numbers of deaths by cause were obtained from a national registration system.
4. Other: use this code if none of the other codes are applicable. Please describe clearly in Item 8 the source of information if "other" is coded.

Item 7

Type or print the name of the person completing this form and the date completed in the spaces provided. Note that this form is to be completed by the Principal Investigator of the MCC or his or her designate.

Item 8

Type or print any reservations or comments about the data that may be helpful to the MDC in using the data or preparing summary reports. Note especially the instructions for items 3 and 6. If necessary, attach additional sheets.