A E Smith Sehdev1, G M Hutchins. 1. Department of Pathology, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287-6901, USA.
Abstract
BACKGROUND: Mortality statistics are largely based on death certificates, so it is important that the data on the death certificate is accurate. At our institution, clinicians complete cause-of-death statements (CODs) prior to autopsy. Since May 1995, separate CODs have been included in autopsy face sheets. METHODS: Clinical and autopsy-based CODs filled out separately on 494 cases between June 1995 and February 1997 were compared for proper reporting and accuracy using the published guidelines and definitions of immediate, intermediate, and underlying causes of death put forth by the College of American Pathologists and the National Center for Health Statistics. RESULTS: Of the 494 death certificates, 204 (41%) contained improperly completed CODs. Of these, 49 (24%) contained major discrepancies between clinicians' and pathologists' CODs. Of the 494 death certificates, 290 (59%) had properly completed CODs. Of the 290 properly completed CODs, 141 (49%) contained disagreements: 73 (52%) on underlying CODs; 44 (31%) on immediate CODs; and 47 (33%) on other significant conditions (part II). CONCLUSIONS: 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.
BACKGROUND: Mortality statistics are largely based on death certificates, so it is important that the data on the death certificate is accurate. At our institution, clinicians complete cause-of-death statements (CODs) prior to autopsy. Since May 1995, separate CODs have been included in autopsy face sheets. METHODS: Clinical and autopsy-based CODs filled out separately on 494 cases between June 1995 and February 1997 were compared for proper reporting and accuracy using the published guidelines and definitions of immediate, intermediate, and underlying causes of death put forth by the College of American Pathologists and the National Center for Health Statistics. RESULTS: Of the 494 death certificates, 204 (41%) contained improperly completed CODs. Of these, 49 (24%) contained major discrepancies between clinicians' and pathologists' CODs. Of the 494 death certificates, 290 (59%) had properly completed CODs. Of the 290 properly completed CODs, 141 (49%) contained disagreements: 73 (52%) on underlying CODs; 44 (31%) on immediate CODs; and 47 (33%) on other significant conditions (part II). CONCLUSIONS: 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.
Authors: Linda Kachuri; Jens Helby; Stig Egil Bojesen; David C Christiani; Li Su; Xifeng Wu; Adonina Tardón; Guillermo Fernández-Tardón; John K Field; Michael P Davies; Chu Chen; Gary E Goodman; Frances A Shepherd; Natasha B Leighl; Ming S Tsao; Yonathan Brhane; M Catherine Brown; Kevin Boyd; Daniel Shepshelovich; Lei Sun; Christopher I Amos; Geoffrey Liu; Rayjean J Hung Journal: Cancer Epidemiol Biomarkers Prev Date: 2019-07 Impact factor: 4.254
Authors: Lena E Winestone; Kelly D Getz; Tamara P Miller; Yimei Li; Yuan-Shung Huang; Alix E Seif; Brian T Fisher; Richard Aplenc Journal: Pediatr Blood Cancer Date: 2017-07-20 Impact factor: 3.167
Authors: Ian R H Rockett; Shuhui Wang; Steven Stack; Diego De Leo; James L Frost; Alan M Ducatman; Rheeda L Walker; Nestor D Kapusta Journal: BMC Psychiatry Date: 2010-05-19 Impact factor: 3.630