Problems With Proper Completion and Accuracy of the Cause-of-Death Statement

Abstract

The reliability and accuracy of CODs remain a significant problem. Despite its limitations, the autopsy remains the best standard against which to judge premortem diagnoses. The CODs of the death certificate may be improved if death certificates are completed in conjunction with the postmortem examination and amended when the autopsy findings show a discrepancy.

Tobacco smoking and alcohol drinking at diagnosis of head and neck cancer and all‐cause mortality: Results from head and neck 5000, a prospective observational cohort of people with head and neck cancer

“…Previous studies suggest that death from non‐cancerous causes (competing mortality) and second primary malignancies are important events in HNC52 and could provide greater insight into the biological mechanisms that underlie the associations of smoking and drinking with survival. The cause of death information on a death certificate is often inaccurate however 53. Accuracy of all‐cause mortality is solely dependent on the number of deaths identified, and is arguably a more reliable outcome measure.…”

Prevalence and risk factors for heart disease among males with hemophilia

“…Problems with death certificate information, including form completion errors and lack of understanding of the definitions of both cause and underlying cause of death, result in accuracy rates of about 50% [16]. In addition, certain causes of death have been shown to be more likely to be incorrect.…”

Are the Assessment of Spondyloarthritis International Society Classification Criteria Useful in Juvenile Spondyloarthritis? Comment on the Article by Weiss et al

“…The International League of Associations for Rheumatology (ILAR) juvenile idiopathic arthritis (JIA) classification criteria define sacroiliitis as the presence of tenderness on direct compression over the sacroiliac joint (2). The sensitivity and specificity for this definition of sacroiliitis for positive findings on MRI in our prospective cross-sectional study of 40 children with newly diagnosed juvenile SpA was 0.25 (interquartile range [IQR] 0.00-0.55) and 0.53 (IQR 0.36-0.71).…”

“…Over the past few decades, trained chronic disease epidemiologists in the NHS, blinded to exposure status in this analysis, have systematically determined a single cause of death as the underlying condition that resulted in death. These abstractors determined cause of death by using all available medical records (e.g., discharge summaries, imaging, clinical notes, and autopsy records) and not relying only on death certificates, which are known to misclassify the cause of death (2). These methods are a major strength of analyses in the NHS investigating chronic diseases and mortality (3).…”

“…Noteworthy was the definition of inflammatory back pain (IBP) in this study, which was adapted from the Assessment of Spondyloarthritis international Society (ASAS) criteria for adults. Although not specifically mentioned, the MRI definition of active sacroilitis was also adapted from the ASAS/Outcome Measures in Rheumatology definition, which was updated recently (2). The study by Weiss et al is an elegant piece of work that has suggested screening for sacroilitis with MRI in all children with juvenile SpA who are HLA-B27 positive, particularly with elevated C-reactive protein levels.…”