Accuracy of Death Certificates and Assessment of Factors for Misclassification of Underlying Cause of Death
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- Mieno Makiko Naka
- Department of Medical Informatics, Center for Information, Jichi Medical University
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- Tanaka Noriko
- Biostatistics Section, Department of Clinical Research and Informatics, Clinical Research Center, National Center for Global Health and Medicine
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- Arai Tomio
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital
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- Kawahara Takuya
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, the University of Tokyo
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- Kuchiba Aya
- Department of Biostatistics, National Cancer Center
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- Ishikawa Shizukiyo
- Center for Community Medicine, Jichi Medical University
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- Sawabe Motoji
- Section of Molecular Pathology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University
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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.<BR>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.<BR>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%.<BR>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.
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ
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Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ 26 (4), 191-198, 2016
日本疫学会