Document Detail

Validity of death certificates for injury-related causes of death.
MedLine Citation:
PMID:  2683747     Owner:  NLM     Status:  MEDLINE    
Exploration of the validity of death certificate information for classifying underlying causes of death has historically focused on "natural" or disease-related causes of death. Current interest in injury-related deaths has emphasized the need for proper certification and coding of these deaths. In this study, the authors compared agreement of the underlying cause of death as determined from death certificate information with that determined from an independent review of all relevant medical and legal documents of death by a panel of physicians. The study sample included all deaths (n = 446) occurring over an approximately 18-year follow-up period (1965-1983) in a randomly selected cohort of 18,313 US Army Veterans of the Vietnam era. Using the physician panel as the "gold standard," sensitivity and specificity were 90% or greater for broad groupings of motor vehicle crash deaths (International Classification of Diseases, Ninth Revision (ICD-9), codes E810-E825), suicides (codes E950-E959), and homicides (codes E960-E969). Agreement for deaths from unintentional poisonings (codes E850-E869), mostly drug- and alcohol-related, was poor (sensitivity, 50 percent); in general, the ICD-9 drug- and alcohol-specific nomenclature is difficult to apply. The specificity and sensitivity for the individual three-digit suicide and homicide codes were all greater than 90%, and although the specificity for three-digit motor vehicle crash deaths was also above 90%, the sensitivity was lower, from 29% to 83%. Agreement on the fourth digit of ICD-9--for example, the role of the decedent in a motor vehicle crash death--was generally poor. The lack of descriptive information on death certificates to allow detailed coding was chiefly responsible for the poor agreement.
L A Moyer; C A Boyle; D A Pollock
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of epidemiology     Volume:  130     ISSN:  0002-9262     ISO Abbreviation:  Am. J. Epidemiol.     Publication Date:  1989 Nov 
Date Detail:
Created Date:  1989-12-06     Completed Date:  1989-12-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7910653     Medline TA:  Am J Epidemiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1024-32     Citation Subset:  IM    
Division of Chronic Disease Control, Center for Environmental Health and Injury Control, Atlanta, GA.
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MeSH Terms
Cause of Death*
Cohort Studies
Death Certificates*
Follow-Up Studies
Random Allocation
Sensitivity and Specificity
Wounds and Injuries / epidemiology,  mortality*

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

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