TY - JOUR
T1 - Inconsistent classification of unexplained sudden deaths in infants and children hinders surveillance, prevention and research
T2 - recommendations from The 3rd International Congress on Sudden Infant and Child Death
AU - The 3rd International Congress on Sudden Infant and Child Death
AU - Goldstein, Richard D.
AU - Blair, Peter S.
AU - Sens, Mary Ann
AU - Shapiro-Mendoza, Carrie K.
AU - Krous, Henry F.
AU - Rognum, Torleiv O.
AU - Moon, Rachel Y.
AU - Anderson, Robert N.
AU - Bundock, Elizabeth A.
AU - Crandall, Laura G.
AU - Darnall, Robert A.
AU - Goldstein, Richard D.
AU - Hauck, Fern
AU - Haynes, Robin L.
AU - Himes, Barbara
AU - Hollander, Susan
AU - Holm, Ingrid A.
AU - Keywan, Christine
AU - McEntire, Betty
AU - Mitchell, Edwin A.
AU - Sperhake, Jan
AU - Sampson, Barbara A.
AU - Super, Mark
N1 - Publisher Copyright:
© 2019, The Author(s).
PY - 2019/12/1
Y1 - 2019/12/1
N2 - This report details the proceedings and conclusions from the 3rd International Congress on Unexplained Deaths in Infants and Children, held November 26–27, 2018 at the Radcliffe Institute at Harvard University. The Congress was motivated by the increasing rejection of the diagnosis Sudden Infant Death Syndrome (SIDS) in the medical examiner community, leading to falsely depressed reported SIDS rates and undermining the validity and reliability of the diagnosis, which remains a leading cause of infant and child mortality. We describe the diagnostic shift away from SIDS and the practical issues contributing to it. The Congress was attended by major figures and opinion leaders in this area from countries significantly engaged in this problem. Four categories (International Classification of Diseases (ICD)-11 categories of MH11, MH12, MH14, PB00-PB0Z) were recommended for classification, and explicit definitions and guidance were provided for death certifiers. SIDS was reframed as unexplained sudden death in infancy or SIDS/MH11 to emphasize that either term signifies the lack of explanation following a rigorous investigation. A distinct category for children over the age of 1 was recommended (MH12). Definitions and exclusions were provided for the alternative categories of accidental asphyxia and undetermined. As recommended, unexplained sudden death in infancy or SIDS on a death certificate will code a unique, trackable entity, accurately reflecting the inability to determine a definitive explanation, while satisfying surveillance needs and reliable identification for research efforts. The conclusions will be submitted to the World Health Organization for inclusion in the upcoming ICD-11.
AB - This report details the proceedings and conclusions from the 3rd International Congress on Unexplained Deaths in Infants and Children, held November 26–27, 2018 at the Radcliffe Institute at Harvard University. The Congress was motivated by the increasing rejection of the diagnosis Sudden Infant Death Syndrome (SIDS) in the medical examiner community, leading to falsely depressed reported SIDS rates and undermining the validity and reliability of the diagnosis, which remains a leading cause of infant and child mortality. We describe the diagnostic shift away from SIDS and the practical issues contributing to it. The Congress was attended by major figures and opinion leaders in this area from countries significantly engaged in this problem. Four categories (International Classification of Diseases (ICD)-11 categories of MH11, MH12, MH14, PB00-PB0Z) were recommended for classification, and explicit definitions and guidance were provided for death certifiers. SIDS was reframed as unexplained sudden death in infancy or SIDS/MH11 to emphasize that either term signifies the lack of explanation following a rigorous investigation. A distinct category for children over the age of 1 was recommended (MH12). Definitions and exclusions were provided for the alternative categories of accidental asphyxia and undetermined. As recommended, unexplained sudden death in infancy or SIDS on a death certificate will code a unique, trackable entity, accurately reflecting the inability to determine a definitive explanation, while satisfying surveillance needs and reliable identification for research efforts. The conclusions will be submitted to the World Health Organization for inclusion in the upcoming ICD-11.
KW - Accidental suffocation and strangulation in bed
KW - Postneonatal mortality
KW - Sudden infant death syndrome
KW - Sudden unexpected infant death
KW - Sudden unexplained death in childhood
KW - Sudden unexplained infant death
KW - Undetermined infant death
UR - http://www.scopus.com/inward/record.url?scp=85073940258&partnerID=8YFLogxK
U2 - 10.1007/s12024-019-00156-9
DO - 10.1007/s12024-019-00156-9
M3 - Comment/debate
C2 - 31502215
AN - SCOPUS:85073940258
SN - 1547-769X
VL - 15
SP - 622
EP - 628
JO - Forensic Science, Medicine, and Pathology
JF - Forensic Science, Medicine, and Pathology
IS - 4
ER -