Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death
Background: Cause of death (COD) information taken from death certificates is often inaccurate and incomplete. However, the accuracy of Underlying CODs (UCODs) recorded on death certificates has not been comprehensively described when multiple diseases are present. Methods: A total of 450 consecuti...
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| Format: | Article |
| Language: | English |
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Japan Epidemiological Association
2016-04-01
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| Series: | Journal of Epidemiology |
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| Online Access: | https://www.jstage.jst.go.jp/article/jea/26/4/26_JE20150010/_pdf |
| _version_ | 1818682630061686784 |
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| author | Makiko Naka Mieno |
| author_facet | Makiko Naka Mieno |
| author_sort | Makiko Naka Mieno |
| collection | DOAJ |
| description | Background: Cause of death (COD) information taken from death certificates is often inaccurate and incomplete. However, the accuracy of Underlying CODs (UCODs) recorded on death certificates has not been comprehensively described when multiple diseases are present.
Methods: A total of 450 consecutive autopsies performed at a geriatric hospital in Japan between February 2000 and August 2002 were studied. We evaluated the concordance rate, sensitivity, and specificity of major UCODs (cancer, heart disease, and pneumonia) reported on death certificates compared with a reference standard of pathologist assessment based on autopsy data and clinical records. Logistic regression analysis was performed to assess the effect of sex, age, comorbidity, and UCODs on misclassification.
Results: The concordance rate was relatively high for cancer (81%) but low for heart disease (55%) and pneumonia (9%). The overall concordance rate was 48%. Sex and comorbidity did not affect UCOD misclassification rates, which tended to increase with patient age, although the association with age was also not significant. The strongest factor for misclassification was UCODs (P < 0.0001). Sensitivity and specificity for cancer were very high (80% and 96%, respectively), but sensitivity for heart disease and pneumonia was 60% and 46%, respectively. Specificity for each UCOD was more than 85%.
Conclusions: Researchers should be aware of the accuracy of COD data from death certificates used as research resources, especially for cases of elderly patients with pneumonia. |
| first_indexed | 2024-12-17T10:21:53Z |
| format | Article |
| id | doaj.art-a1259d7a207f4f139328b4e32f94c820 |
| institution | Directory Open Access Journal |
| issn | 0917-5040 1349-9092 |
| language | English |
| last_indexed | 2024-12-17T10:21:53Z |
| publishDate | 2016-04-01 |
| publisher | Japan Epidemiological Association |
| record_format | Article |
| series | Journal of Epidemiology |
| spelling | doaj.art-a1259d7a207f4f139328b4e32f94c8202022-12-21T21:52:46ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922016-04-0126419119810.2188/jea.JE20150010Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of DeathMakiko Naka Mieno0 Department of Medical Informatics, Center for Information, Jichi Medical UniversityBackground: Cause of death (COD) information taken from death certificates is often inaccurate and incomplete. However, the accuracy of Underlying CODs (UCODs) recorded on death certificates has not been comprehensively described when multiple diseases are present. Methods: A total of 450 consecutive autopsies performed at a geriatric hospital in Japan between February 2000 and August 2002 were studied. We evaluated the concordance rate, sensitivity, and specificity of major UCODs (cancer, heart disease, and pneumonia) reported on death certificates compared with a reference standard of pathologist assessment based on autopsy data and clinical records. Logistic regression analysis was performed to assess the effect of sex, age, comorbidity, and UCODs on misclassification. Results: The concordance rate was relatively high for cancer (81%) but low for heart disease (55%) and pneumonia (9%). The overall concordance rate was 48%. Sex and comorbidity did not affect UCOD misclassification rates, which tended to increase with patient age, although the association with age was also not significant. The strongest factor for misclassification was UCODs (P < 0.0001). Sensitivity and specificity for cancer were very high (80% and 96%, respectively), but sensitivity for heart disease and pneumonia was 60% and 46%, respectively. Specificity for each UCOD was more than 85%. Conclusions: Researchers should be aware of the accuracy of COD data from death certificates used as research resources, especially for cases of elderly patients with pneumonia.https://www.jstage.jst.go.jp/article/jea/26/4/26_JE20150010/_pdfaccuracyautopsydeath certificatesoutcome misclassificationunderlying cause of death |
| spellingShingle | Makiko Naka Mieno Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death Journal of Epidemiology accuracy autopsy death certificates outcome misclassification underlying cause of death |
| title | Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death |
| title_full | Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death |
| title_fullStr | Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death |
| title_full_unstemmed | Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death |
| title_short | Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death |
| title_sort | accuracy of death certificates and assessment of factors for misclassification of underlying cause of death |
| topic | accuracy autopsy death certificates outcome misclassification underlying cause of death |
| url | https://www.jstage.jst.go.jp/article/jea/26/4/26_JE20150010/_pdf |
| work_keys_str_mv | AT makikonakamieno accuracyofdeathcertificatesandassessmentoffactorsformisclassificationofunderlyingcauseofdeath |