Substance-Related Acute Toxicity Deaths in Canada From 2016 to 2017: Protocol for a Retrospective Chart Review Study of Coroner and Medical Examiner Files
Notice bibliographique
Résumé
BACKGROUND: Canada continues to experience a national overdose crisis. While studies are available at the regional, provincial, and territorial levels, detailed national data regarding the burden and context of substance-related acute toxicity deaths are limited, particularly in subpopulations. In response to the overdose crisis, the Public Health Agency of Canada, in collaboration with provincial and territorial ministries of health and chief coroner and chief medical examiner offices, has undertaken a national chart review study. OBJECTIVE: This study was conducted to describe and compare the characteristics of substance-related acute toxicity deaths that occurred in Canada between 2016 and 2017, including descriptions of those who died, the substances involved, and the circumstances surrounding their deaths. This paper describes the study methodology in detail. METHODS: This retrospective, population-based, and cross-sectional study involved the review of coroner and medical examiner files for deaths that met the study case definition. Data were collected on demographic and socioeconomic characteristics, medical and substance use history, proximal circumstances surrounding the death, and toxicology findings using a standardized data collection tool that underwent 2 pilot studies. Data abstractors underwent training and regular intrarater reliability exercises with a fictitious death investigation file. Data quality was assessed based on the consistency of abstractor intrarater reliability scores and the completeness of core variables and variables for key concepts. Data were linked to national datasets to allow for the examination of area-level geographic and socioeconomic characteristics. Descriptive analyses will examine differences across subpopulations and the general Canadian population. Latent class, spatiotemporal, qualitative, and premature death analyses are also planned. Where possible, analyses will be stratified by the manner of death and sex. RESULTS: The study began in the summer of 2018, and abstraction was delayed due to the COVID-19 pandemic. All activities are expected to be completed by early 2025. A total of 9414 coroner and medical examiner files met the study case definition. Most abstractors (25/26, 96%) met the established threshold for consistency throughout abstraction without the need for remedial training. In general, core study variables, including geographic variables and substances contributing to death, had very good availability. Study variables related to the person's health, history of substance use, and events surrounding the acute toxicity event were available for most records. Socioeconomic variables and variables describing socially constructed identities and potentially traumatic life events were mostly unavailable. CONCLUSIONS: This study provides the most detailed national information on substance-related acute toxicity deaths in Canada to date and can serve as a pre-COVID-19 pandemic baseline for assessing the evolution of the overdose crisis. Results can inform policies and programs to address the overdose crisis, the development of common approaches to medicolegal death investigations, and future research activities.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,041 | 0,038 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,003 |
| Méta-épidémiologie (sens large) | 0,003 | 0,002 |
| Bibliométrie | 0,009 | 0,010 |
| Études des sciences et des technologies | 0,009 | 0,003 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,004 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,004 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».