CoChat
Sign Up
Cited by 95Medical Coding and Health InformationAutopsy Techniques and OutcomesStatistical Methods in Epidemiology

The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.

Ill-defined and multiple causes on death certificates – A study of misclassification in mortality statistics

D'Amico, M., Agozzino, E., Biagino, A., Simonetti, A., Marinelli, P.·1999·European Journal of Epidemiology
DOI 10.1023/a:1007570405888
Open this paper in CoChat — free account

Abstract

Biases can distort, limit or inhibit the value of mortality data as an epidemiological re source. From 9500 deaths occurring in Naples (Italy during 1994, a random sample of 372 death certificates reporting ill-defined causes and multiple causes of death was extracted. The code for the underlying cause on the death certificate (assigned code) was compared with the cause reattributed with the aid of interview of the certifying physician or clinical records (modified code). The aim was to investigate the extent of misclassification of 'underlying cause' in deaths attributed to ill-defined and/or multiple causes and the shortcomings in the ICD-IX. Ill-defined underlying causes of death (7.0% of death certificates) were cardiovascular diseases, tumours with no specified site or nature, symptoms, signs, ill-defined conditions and senility. There was disagreement between the initially assigned code and the modified code in 53.8% of ill-defined underlying causes; discordance was high for the certificates filled in by the family physician. Multiple causes of death were observed in 23.6% of certificates; of these 59.2% concerned subjects aged 75 years and over at death. Diabetes was always listed in association with other pathologies but neoplasms and traumas were generally listed alone. Disagreement between codes occurred in 48 (54.5%) certificates indicating multiple causes. In 10 of them, death was established as due to a concurrence of causes. As regards ill-defined causes of death, the authors concluded that specific training on certifying procedures would be insufficient on their own; the physician should be made aware that certification is a fundamental requirement for building up epidemiological data. Evidence-based educational interventions are needed. As regards multiple causes of death, multicausal analysis may be indicated for deaths due to a concurrence of causes.

Overview

Integrity signals

Registry

Crossref · 10.1023/a:1007570405888

Cites

41 of 41 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Research works printed but not linked: 1

  1. Barchielli A, Geddes M. Le cause di morte non adeguatamente definite nelle statistiche di mortalità italiane. L'Igiene Moderna 1984; 81: 1075–1091.

Cited by

Sorted by citations

See all 95

Related

See all

Metadata

Authors
D'Amico, M., Agozzino, E., Biagino, A., Simonetti, A., & Marinelli, P.
Affiliations
University of Campania "Luigi Vanvitelli" (IT)
ORCID
Venue
European Journal of Epidemiology
Publisher
Springer Science and Business Media LLC
Published
1999-02
Volume
15
Issue
2
Pages
141-148
ISSN
  • 0393-2990 (ISSN-L)
  • 1573-7284
DOI
10.1023/a:1007570405888
OpenAlex
W1549254396
Cited by
95
References
41
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 8 · 2015: 2 · 2014: 4 · 2013: 4 · 2012: 6
FWCI
4.56
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • European Journal of Epidemiology (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Autopsy Techniques and Outcomes
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Keywords
death certificates, misclassification, underlying cause of death, ill-defined causes of death, multiple cause of death, ICD-9, cause of death certification, mortality data quality, Naples
MeSH terms
Age Factors, Aged, Cardiovascular Diseases, Cause of Death, Classification, Community Medicine, Death Certificates, Diabetes Mellitus, Family Practice, Humans, Italy, Medical Staff, Hospital, Mortality, Neoplasms, Wounds and Injuries, Bias, Epidemiologic Studies, Evidence-Based Medicine

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review