Document Detail

Agreement on cause of death between proxies, death certificates, and clinician adjudicators in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.
MedLine Citation:
PMID:  21540327     Owner:  NLM     Status:  MEDLINE    
Death certificates may lack accuracy and misclassify the cause of death. The validity of proxy-reported cause of death is not well established. The authors examined death records on 336 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a national cohort study of 30,239 community-dwelling US adults (2003-2010). Trained experts used study data, medical records, death certificates, and proxy reports to adjudicate causes of death. The authors computed agreement on cause of death from the death certificate, proxy, and adjudication, as well as sensitivity and specificity for certain diseases. Adjudicated cause of death had a higher rate of agreement with proxy reports (73%; Cohen's kappa (κ) statistic = 0.69) than with death certificates (61%; κ = 0.54). The agreement between proxy reports and adjudicators was better than agreement with death certificates for all disease-specific causes of death. Using the adjudicator assessments as the "gold standard," for disease-specific causes of death, proxy reports had similar or higher specificity and higher sensitivity (sensitivity = 50%-89%) than death certificates (sensitivity = 31%-81%). Proxy reports may be more concordant with adjudicated causes of death than with the causes of death listed on death certificates. In many settings, proxy reports may represent a better strategy for determining cause of death than reliance on death certificates.
Jewell H Halanych; Faisal Shuaib; Gaurav Parmar; Rajasekhar Tanikella; Virginia J Howard; David L Roth; Ronald J Prineas; Monika M Safford
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-05-03
Journal Detail:
Title:  American journal of epidemiology     Volume:  173     ISSN:  1476-6256     ISO Abbreviation:  Am. J. Epidemiol.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-25     Completed Date:  2011-08-09     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  7910653     Medline TA:  Am J Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1319-26     Citation Subset:  IM    
School of Medicine, University of Alabama at Birmingham, 1530 3rd Avenue South, Birmingham, AL 35294-4410, USA.
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MeSH Terms
African Americans
Cause of Death
Death Certificates*
Epidemiologic Methods*
Medical Records / statistics & numerical data*
Prospective Studies
Proxy / statistics & numerical data*
Reproducibility of Results
Socioeconomic Factors
Stroke / ethnology,  mortality*
United States / epidemiology
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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