Quality assessment of the forensic surveillance system: A data-quality monitoring system for substance-abuse detection in unnatural deaths in Thailand.

Abstract

This study aimed to assess the reliability and identify sources of discrepancies to strengthen data governance and system integrity of the national forensic toxicology surveillance database from postmortem examinations called by the Forensic Drug Abuse Monitoring Network (FDAMN), Thailand. A facility-based cross-sectional study was conducted across 25 forensic institutions participating in the FDAMN. 10% (1441 cases) of postmortem toxicology records during January 1 to December 31, 2021, were randomly selected for independent re-entering records for verification during fiscal year 2023. Subsequently, 638,100 paired data points from the original and re-entered datasets were compared. Data consistency was analyzed using descriptive statistics, and a qualitative review was performed to identify underlying causes of discrepancies. A total of 1418 matched records (98.4%) were successfully verified. All of the data fields were identical between the datasets in 98.5% of cases, with 1.5% showing discrepancies. Administrative variables exhibited 96.3% consistency, while demographic and toxicological data exceeded 94% consistency. Circumstance variables, such as the date and time of death, showed the highest discrepancy rate (6.0%). Most inconsistencies arose from administrative coding variations, typographical errors, and/or legitimate data updates following confirmatory analyses. Thailand's national forensic toxicology surveillance database demonstrates high data consistency, thereby affirming the robustness of the FDAMN system. Remaining discrepancies are primarily procedural and can be mitigated through standardization of coding, automation of data-validation checks, and feedback-driven quality improvement. These findings may provide a practical framework for strengthening forensic drug surveillance systems and data-quality assurance in other countries facing evolving illicit drug threats.