Purpose of CDR Reporting
Child Death Review Case Reporting System
CDR Data for Annual Reports
of CDR Reporting
individual case review of a childís death can
often catalyze local and state action to prevent
other deaths. It is important, however, to
systematically collect data and report on the
findings from your reviews over time. It is also
important to compare your review findings with
your child mortality data from vital statistics
and other official records.
data from a series or cluster of case reviews are
analyzed over time, significant risk factors or
patterns in child injury and safety can be
identified. The collection of findings from case
reviews and the subsequent reporting out on these
findings can help:
teams gain support for local interventions.
teams review local findings to identify
trends, major risk factors and to develop
recommendations and action plans for state
policy and practice improvements.
teams match review findings with vital records
and other sources of mortality data to
identify gaps in the reporting of deaths.
and local teams use the findings as a quality
assurance tool for their review processes.
teams and states use the reports to
demonstrate the effectiveness of their reviews
and advocate for funding and support for their
groups use state and local CDR findings for
policy and practice changes.
of January 2005, review teams in forty four states
in the U.S. were using some type of case reporting
tool, although no two states were using the same
tool. States were using these case reports to
develop annual reports to state legislators,
governors, state agencies and the public.
Thirty-nine states were
publishing annual reports with findings
and recommendations. Eighteen states
had legislation in place requiring these
individual case report is completed on all deaths
reviewed by a team. It should include information
on the child, caregivers, supervisors,
circumstances of the event leading to the death
and team findings related to services and
prevention. When completed following case reviews,
tabulations of and analysis of the data from the
case reports will provide:
information on the child, family and
factors in the child deaths reviewed.
of the investigation activities conducted as a
result of this death.
of the services provided or needed as a result
of the deaths reviewed, and the review teams
recommendations for new services or referrals.
teamís recommendations and actions taken for
the prevention of other deaths.
affecting the quality of the case review
should ensure that the legislation and/or rules
regulating your CDR process allow for the
collection of a case report. Some states do not
allow for case identifiable data to be collected
or shared at the state level, so the case report
will need to have these identifiers removed.
case report can be partially completed prior to
the case review. Your team coordinator may provide
these forms to team members prior to the meeting,
but should be sure to take the necessary steps to
protect confidentiality. The case report should be
completed during or shortly after a review. The
data elements in the form can be helpful in
guiding a discussion. However, the case report
tool should not be the focus of the review, nor
inhibit the flow of discussion. The person
responsible for the case report should enter data
from the report into a predesigned database for
child death review. This data can then be
tabulated and analyzed for specific time periods,
e.g. annually, for inclusion in a report on CDR
for either local or state distribution.
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Death Review Case Reporting System
is now a standardized case report tool available
to states through the National Center for Child
Death Review. A work group of over 30 persons,
representing 18 states, worked to develop a set of
standardized data elements and data definitions
case report is part of the Child Death Review Case Reporting System,
a web-based application. The system allows local and state users to enter case data,
access and download their data and download standardized reports via the Internet. Users are
able to complete data analysis and develop their own reports. With data use agreements
between states, users may be able to compare their data with other states and
with national compilations. This standardized CDR Case Reporting System began
a pilot phase in 14 states in May 2006 and Version 1 was made
available for widespread use in January 2007. Version 2.0 was introduced in Janary 2008.
CDR Data for Annual Reports
and disseminating CDR case findings into reports
is an effective means of educating policy makers,
agency staff and the general public about key
risks factors and opportunities for prevention.
Most of these compilations are done as annual
reports or as a two or three-year summary of
findings. These reports can include the following:
Summary that includes child mortality data,
CDR findings, prevention recommendations and
an overview of the CDR process.
of child mortality data, including numbers and
rates for all child deaths.
of child death review team findings for all
deaths by key indicators collected in the case
mortality data including numbers and rates and
child death review findings by specific
manners and causes.
every section include:
data by year and trends over ten years if
general description of the cause of death,
relative to national data, key risk factors,
known proven interventions to prevent the
deaths, and resources available for more
by age, race, ethnicity and gender.
risk factors identified through the review
taken as a result of the reviews locally or at
the state level.
for state and local leaders.
for parents and caregivers.
could include a list of figures and tables, number
of cases reviewed and reported by teams, total
number of deaths among state residents, ages 0-18,
by county of residence and age group, total number
of deaths among state residents, ages 0-18, by
county of residence and year of death and list of
review team coordinators.
the report on CDR findings can be difficult and
time consuming, especially for persons not
accustomed to data analysis systems. Public health
departments often have data analysis staff and
epidemiologists that may be able to assist in the
preparation of the report. Caution should be taken
when presenting both mortality data from vital
statistics and child death review data. Often
these two sources of data cannot be compared
Often the year of deaths and year of reviews may
differ, there may be children in one or the other
data set that are not residents of the
jurisdiction being reported on and there may be
significant delays in obtaining mortality data, as
compared to CDR data.
these caveats, it is important to present both
mortality data and CDR data. By doing this you
will be able to estimate the percent of reviews
being completed in comparison to all child deaths,
you may be able to identify areas that may be
underreported through the vital statistics coding
system (child abuse fatalities for example) and
you will have a more complete understanding of all
the child deaths in your reporting area.
is important to have a plan in place for
disseminating the reports and for following
on the recommendations in the report. Many states
have been effective in distributing the reports to
state legislators, state executive offices, state
agency administrators, state child advocates, the
press and local CDR team members. You should work
with your state agency to develop a press release
and events to publicize the reportís release.
of state reports are available in the State
Spotlight section for each state.