Ill-defined and multiple causes on death certificates : A study of misclassification in mortality statistics.
Biases can distort, limit or inhibit the value of mortality data as an epidemiological resource.
From 9500 deaths occurring in Naples (Italy) during 1994. a random sample of 372 death certificates reporting ill-defined causes and multiple causes of death was extracted.
The code for the underlying cause on the death certificate (assigned code) was compared with the cause reattributed with the aid of interview of the certifying physician or clinical records (modified code).
The aim was to investigate the extent of misclassification of underlying cause'in deaths attributed to ill-defined and/or multiple causes and the shortcomings in the ICD-IX.
Ill-defined underlying causes of death (7.0% of death certificates) were cardiovascular diseases, tumours with no specified site or nature, symptoms, signs, ill-defined conditions and senility.
There was disagreement between the initially assigned code and the modified code in 53.8% of ill-defined underlying causes ; discordance was high for the certificates filled in by the family physician.
Multiple causes of death were observed in 23.6% of certificates ; of these 59.2% concerned subjects aged 75 years and over at death.
Diabetes was always listed in association with other pathologies but neoplasms and traumas were generally listed alone.
Disagreement between codes occurred in 48 (54.5%) certificates indicating multiple causes.
In 10 of them, death was established as due to a concurrence of causes. (...)
Mots-clés Pascal : Italie, Europe, Epidémiologie, Homme, Santé, Mortalité, Certificat décès, Cause, Randomisation, Etude longitudinale, Evaluation, Statistique sanitaire
Mots-clés Pascal anglais : Italy, Europe, Epidemiology, Human, Health, Mortality, Death certificate, Cause, Randomization, Follow up study, Evaluation, Sanitary statistics
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0192501
Code Inist : 002B30A01A2. Création : 16/11/1999.