Title | Validation of death certificate diagnosis for coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) Study. |
Publication Type | Journal Article |
Year of Publication | 2001 |
Authors | Coady SA, Sorlie PD, Cooper LS, Folsom AR, Rosamond WD, Conwill DE |
Journal | J Clin Epidemiol |
Volume | 54 |
Issue | 1 |
Pagination | 40-50 |
Date Published | 2001 Jan |
ISSN | 0895-4356 |
Keywords | Abstracting and Indexing, Adult, Age Distribution, Aged, Bias, Cause of Death, Coronary Disease, Death Certificates, Female, Hospital Mortality, Humans, Male, Maryland, Medical Records, Middle Aged, Minnesota, Mississippi, North Carolina, Population Surveillance, Residence Characteristics, Sensitivity and Specificity, Sex Distribution, Surveys and Questionnaires |
Abstract | The validity of the death certificate in identifying coronary heart disease deaths was evaluated using data from the community surveillance component of the Atherosclerosis Risk in Communities Study (ARIC). Deaths in the four ARIC communities of Forsyth Co., NC; Jackson, MS; Minneapolis, MN; and Washington Co., MD were selected based on underlying cause of death codes as determined by the rules of the ninth revision of the International Classification of Diseases (ICD-9). Information about the deaths was gathered through informant interviews, physician or coroner questionnaires, and medical record abstraction, and was used to validate the cause of death. Sensitivity, specificity, and positive predictive value of the death certificate classification of CHD death (ICD-9 codes 410-414 and 429.2) were estimated by comparison with the validated cause of death based on physician review of all available information. Results from 9 years of surveillance included a positive predictive value 0.67 (95% CI 0.66-0.68), sensitivity of 0.81 (95% CI 0.79-0.83), and a false-positive rate (1-specificity) of 0.28 (95% CI 0.26-0.30). Comparing CHD deaths as defined by the death certificate with validated CHD deaths indicated that the death certificate overestimated CHD mortality by approximately 20% in the ARIC communities. Within subgroups, death certificate overestimation was reduced with advancing age (up to age 74), was consistent over time, was not dependent on gender, and exhibited considerable variation among communities. |
DOI | 10.1016/s0895-4356(00)00272-9 |
Alternate Journal | J Clin Epidemiol |
PubMed ID | 11165467 |