Validity of death certificates for coding coronary heart disease as the cause of death in Bahrain

This study aimed to examine the accuracy of death certificates for coding coronary heart disease [CHD] as the underlying cause of death in Bahrain. Of the 1714 deaths occurring in Bahrain in 1993, 371 were classified as resulting from CHD. In this study the hospital diagnosis of 109 deaths [52 as CHD and 57 as other causes]were reviewed and re-diagnosed using hospital records. The coding of 459 death certificates [151 as CHD and 308 as other causes]by the Directorate of Public Health was similarly reviewed. The sensitivity and specificity of the hospital diagnosis were 76% and 72% respectively and those of the Directorate of Public Health were 85% and 89% respectively. National mortality statistics in Bahrain, which are based on death certificate data, may overestimate the frequency of CHD. Therefore, it is important that measures are taken to improve the accuracy of certification

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Reporting of Diabetes on Death Certificates With Coronary Heart Disease as Underlying Cause of Death in California, 1985-1990

Diabetes Care ◽

10.2337/diacare.18.1.135 ◽

1995 ◽

Vol 18 (1) ◽

pp. 135-137 ◽

Cited By ~ 1

Author(s):

S. H. Wild ◽

A. Laws

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cause Of Death ◽

Death Certificates ◽

Underlying Cause Of Death

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The Role of COVID-19 in the Death of SARS-CoV-2–Positive Patients: A Study Based on Death Certificates

Journal of Clinical Medicine ◽

10.3390/jcm9113459 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3459 ◽

Cited By ~ 1

Author(s):

Francesco Grippo ◽

Simone Navarra ◽

Chiara Orsi ◽

Valerio Manno ◽

Enrico Grande ◽

...

Keyword(s):

Heart Disease ◽

Cause Of Death ◽

Hypertensive Heart Disease ◽

International Classification Of Diseases ◽

Death Certificates ◽

Respiratory Complications ◽

Classification Of Diseases ◽

Underlying Cause Of Death ◽

And Gender ◽

Low Prevalence

Background: Death certificates are considered the most reliable source of information to compare cause-specific mortality across countries. The aim of the present study was to examine death certificates of persons who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to (a) quantify the number of deaths directly caused by coronavirus 2019 (COVID-19); (b) estimate the most common complications leading to death; and (c) identify the most common comorbidities. Methods: Death certificates of persons who tested positive for SARS-CoV-2 provided to the National Surveillance system were coded according to the 10th edition of the International Classification of Diseases. Deaths due to COVID-19 were defined as those in which COVID-19 was the underlying cause of death. Complications were defined as those conditions reported as originating from COVID-19, and comorbidities were conditions independent of COVID-19. Results: A total of 5311 death certificates of persons dying in March through May 2020 were analysed (16.7% of total deaths). COVID-19 was the underlying cause of death in 88% of cases. Pneumonia and respiratory failure were the most common complications, being identified in 78% and 54% of certificates, respectively. Other complications, including shock, respiratory distress and pulmonary oedema, and heart complications demonstrated a low prevalence, but they were more commonly observed in the 30–59 years age group. Comorbidities were reported in 72% of certificates, with little variation by age and gender. The most common comorbidities were hypertensive heart disease, diabetes, ischaemic heart disease, and neoplasms. Neoplasms and obesity were the main comorbidities among younger people. Discussion: In most persons dying after testing positive for SARS-CoV-2, COVID-19 was the cause directly leading to death. In a large proportion of death certificates, no comorbidities were reported, suggesting that this condition can be fatal in healthy persons. Respiratory complications were common, but non-respiratory complications were also observed.

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ADJUDICATION PILOT STUDY OF CAUSE OF DEATH IN THE LONG LIFE FAMILY STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.3372 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S926-S926

Author(s):

Habibatou Diallo ◽

Joanne Murabito ◽

Anne B Newman ◽

Thomas T Perls ◽

Diane Ives ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Pilot Study ◽

Cause Of Death ◽

Medical Records ◽

Causes Of Death ◽

Death Certificate ◽

Family Study ◽

Underlying Causes ◽

Long Life

Abstract Background: Death certificate inaccuracy increases at older ages. The Long Life Family Study (LLFS) utilizes a physician adjudication committee to review the death certificate, medical records and a family narrative about cause of death. We report here the adjudication process and the prevalent underlying causes of death for a subsample of those who have died so far. Methods: We first describe the adjudication process. There were ~1,250 deaths in LLFS. We report underlying causes of death for a subset of proband generation subjects enrolled and evaluated by two LLFS study centers. Results: As of May 2019, we have adjudicated 190 deaths (98 male, 92 female) . Mean age 95 years (range 81-105 years). Top 5 causes of death for men: cancer (13%), coronary heart disease (CHD, 13%), dementia (13%), "other" (11%) and "unknown" (9%) and for women: dementia (21%), valvular heart disease (14%), coronary heart disease (12%), unknown (12%) and other (9%). Rate of death due to dementia was greater in women compared to men (CHI2 =7.33, p=0.006). Conclusions: In this pilot study, a significantly greater proportion of women died due to dementia compared to men. At least some portion of this difference may be due to the observation that women are known to survive chronic aging-related diseases more than men and thus have a greater opportunity to die from dementia at advanced ages. An additional cause to consider includes clinicians’ gender bias in ascribing diagnoses in the medical records that were relied upon as part of the adjudication process.

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Accuracy of Death Certificates for Coding Coronary Heart Disease as the Cause of Death

Annals of Internal Medicine ◽

10.7326/0003-4819-129-12-199812150-00005 ◽

1998 ◽

Vol 129 (12) ◽

pp. 1020 ◽

Cited By ~ 252

Author(s):

Donald M. Lloyd-Jones

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cause Of Death ◽

Death Certificates

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Death Certification Errors and the Effect on Mortality Statistics

Public Health Reports ◽

10.1177/0033354917736514 ◽

2017 ◽

Vol 132 (6) ◽

pp. 669-675 ◽

Cited By ~ 36

Author(s):

Lauri McGivern ◽

Leanne Shulman ◽

Jan K. Carney ◽

Steven Shapiro ◽

Elizabeth Bundock

Keyword(s):

Cause Of Death ◽

Primary Objective ◽

Error Rates ◽

Death Certificates ◽

Mortality Statistics ◽

Manner Of Death ◽

Registration System ◽

National Mortality ◽

Icd 10 ◽

Medical Examiners

Objective: Errors in cause and manner of death on death certificates are common and affect families, mortality statistics, and public health research. The primary objective of this study was to characterize errors in the cause and manner of death on death certificates completed by non–Medical Examiners. A secondary objective was to determine the effects of errors on national mortality statistics. Methods: We retrospectively compared 601 death certificates completed between July 1, 2015, and January 31, 2016, from the Vermont Electronic Death Registration System with clinical summaries from medical records. Medical Examiners, blinded to original certificates, reviewed summaries, generated mock certificates, and compared mock certificates with original certificates. They then graded errors using a scale from 1 to 4 (higher numbers indicated increased impact on interpretation of the cause) to determine the prevalence of minor and major errors. They also compared International Classification of Diseases, 10th Revision (ICD-10) codes on original certificates with those on mock certificates. Results: Of 601 original death certificates, 319 (53%) had errors; 305 (51%) had major errors; and 59 (10%) had minor errors. We found no significant differences by certifier type (physician vs nonphysician). We did find significant differences in major errors in place of death ( P < .001). Certificates for deaths occurring in hospitals were more likely to have major errors than certificates for deaths occurring at a private residence (59% vs 39%, P < .001). A total of 580 (93%) death certificates had a change in ICD-10 codes between the original and mock certificates, of which 348 (60%) had a change in the underlying cause-of-death code. Conclusions: Error rates on death certificates in Vermont are high and extend to ICD-10 coding, thereby affecting national mortality statistics. Surveillance and certifier education must expand beyond local and state efforts. Simplifying and standardizing underlying literal text for cause of death may improve accuracy, decrease coding errors, and improve national mortality statistics.

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Evolution of Pathology Patterns in Persons Who Died From COVID-19 in Italy: A National Study Based on Death Certificates

Frontiers in Medicine ◽

10.3389/fmed.2021.645543 ◽

2021 ◽

Vol 8 ◽

Author(s):

Francesco Grippo ◽

Enrico Grande ◽

Alice Maraschini ◽

Simone Navarra ◽

Marilena Pappagallo ◽

...

Keyword(s):

Heart Disease ◽

Cause Of Death ◽

Disease Burden ◽

Hypertensive Heart Disease ◽

National Study ◽

Second Phase ◽

Death Certificates ◽

Epidemic Curve ◽

Underlying Cause Of Death ◽

Serious Disease

Background: In Italy, during the first epidemic wave of 2020, the peak of coronavirus disease 2019 (COVID-19) mortality was reached at the end of March. Afterward, a progressive reduction was observed until much lower figures were reached during the summer, resulting from the contained circulation of SARS-CoV-2. This study aimed to determine if and how the pathological patterns of the individuals deceased from COVID-19 changed during the phases of epidemic waves in terms of: (i) main cause of death, (ii) comorbidities, and (iii) complications related to death.Methods: Death certificates of persons who died and tested positive for SARS-CoV-2, provided by the National Surveillance system, were coded according to ICD rev10. Deaths due to COVID-19 were defined as those in which COVID-19 was the underlying cause of death.Results: The percentage of COVID-19 deaths varied over time. It decreased in the downward phase of the epidemic curve (76.6 vs. 88.7%). In February–April 2020, hypertensive heart disease was mentioned as a comorbidity in 18.5% of death certificates, followed by diabetes (15.9% of cases), ischemic heart disease (13.1%), and neoplasms (12.1%). In May–September, the most frequent comorbidity was neoplasms (17.3% of cases), followed by hypertensive heart disease (14.9%), diabetes (14.8%), and dementia/Alzheimer's disease (11.9%). The most mentioned complications in both periods were pneumonia and respiratory failure with a frequency far higher than any other condition (78.4% in February–April 2020 and 63.7% in May–September 2020).Discussion: The age of patients dying from COVID-19 and their disease burden increased in the May–September 2020 period. A more serious disease burden was observed in this period, with a significantly higher frequency of chronic pathologies. Our study suggests better control of the virus' lethality in the second phase of the epidemic, when the health system was less burdened. Moreover, COVID-19 care protocols had been created in hospitals, and knowledge about the diagnosis and treatment of COVID-19 had improved, potentially leading to more accurate diagnosis and better treatment. All these factors may have improved survival in patients with COVID-19 and led to a shift in mortality to older, more vulnerable, and complex patients.

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Sensitivity and Positive Predictive Value of Death Certificate Data Among Deaths Caused by Legionnaires’ Disease in New York City, 2008-2013

Public Health Reports ◽

10.1177/0033354918782494 ◽

2018 ◽

Vol 133 (5) ◽

pp. 578-583

Author(s):

Olivia C. Tran ◽

David E. Lucero ◽

Sharon Balter ◽

Robert Fitzhenry ◽

Mary Huynh ◽

...

Keyword(s):

New York ◽

New York City ◽

Positive Predictive Value ◽

Cause Of Death ◽

York City ◽

Predictive Value ◽

Death Certificate ◽

Death Certificates ◽

Legionnaires Disease ◽

Underlying Cause Of Death

Objectives: Death certificates are an important source of information for understanding life expectancy and mortality trends; however, misclassification and incompleteness are common. Although deaths caused by Legionnaires’ disease might be identified through routine surveillance, it is unclear whether Legionnaires’ disease is accurately recorded on death certificates. We evaluated the sensitivity and positive predictive value of death certificates for identifying deaths from confirmed or suspected Legionnaires’ disease among adults in New York City. Methods: We deterministically matched death certificate data from January 1, 2008, through December 31, 2013, on New York City residents aged ≥18 years to surveillance data on confirmed and suspected cases of Legionnaires’ disease from January 1, 2008, through October 31, 2013. We estimated sensitivity and positive predictive value by using surveillance data as the reference standard. Results: Of 294 755 deaths, 27 (<0.01%) had an underlying cause of death of Legionnaires’ disease and 33 (0.01%) had any mention of Legionnaires’ disease on the death certificate. Of 1211 confirmed or suspected cases of Legionnaires’ disease, 267 (22.0%) matched to a record in the death certificate data set. The sensitivity of death certificates that listed Legionnaires’ disease as the underlying cause of death was 17.3% and of death certificates with any mention of Legionnaires’ disease was 20.9%. The positive predictive value of death certificates that listed Legionnaires’ disease as the underlying cause of death was 70.4% and of death certificates with any mention of Legionnaires’ disease was 69.7%. Conclusions: Death certificates had limited ability to identify confirmed or suspected deaths with Legionnaires’ disease. Provider trainings on the diagnosis of Legionnaires’ disease, particularly hospital settings, and proper completion of death certificates might improve the sensitivity of death certificates for people who die of Legionnaires’ disease.

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Obscuring effect of coding developmental disability as the underlying cause of death on mortality trends for adults with developmental disability: a cross-sectional study using US Mortality Data from 2012 to 2016

BMJ Open ◽

10.1136/bmjopen-2018-026614 ◽

2019 ◽

Vol 9 (2) ◽

pp. e026614 ◽

Cited By ~ 13

Author(s):

Scott D Landes ◽

James Dalton Stevens ◽

Margaret A Turk

Keyword(s):

Down Syndrome ◽

Cerebral Palsy ◽

Intellectual Disability ◽

Developmental Disabilities ◽

Cause Of Death ◽

Developmental Disability ◽

Death Certificate ◽

Death Certificates ◽

Mortality Trends ◽

Underlying Cause Of Death

ObjectiveTo determine whether coding a developmental disability as the underlying cause of death obscures mortality trends of adults with developmental disability.DesignNational Vital Statistics System 2012–2016 US Multiple Cause-of-Death Mortality files.SettingUSA.ParticipantsAdults with a developmental disability indicated on their death certificate aged 18 through 103 at the time of death. The study population included 33 154 adults who died between 1 January 2012 and 31 December 2016.Primary outcome and measuresDecedents with a developmental disability coded as the underlying cause of death on the death certificate were identified using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code for intellectual disability, cerebral palsy, Down syndrome or other developmental disability. Death certificates that coded a developmental disability as the underlying cause of death were revised using a sequential underlying cause of death revision process.ResultsThere were 33 154 decedents with developmental disability: 7901 with intellectual disability, 11 895 with cerebral palsy, 9114 with Down syndrome, 2479 with other developmental disabilities and 1765 with multiple developmental disabilities. Among all decedents, 48.5% had a developmental disability coded as the underlying cause of death, obscuring higher rates of choking deaths among all decedents and dementia and Alzheimer’s disease among decedents with Down syndrome.ConclusionDeath certificates that recorded the developmental disability in Part I of the death certificate were more likely to code disability as the underlying cause of death. While revising these death certificates provides a short-term corrective to mortality trends for this population, the severity and extent of this problem warrants a long-term change involving more precise instructions to record developmental disabilities only in Part II of the death certificate.

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