Factors in Diagnosis and Classification of Deaths from CVR Diseases

Abstract

Information was obtained on diagnostic data avialable to physicians at the time of certifying causes of death in a sample study in Pennsylvania. These data were evaluated by an internist which indicated that in about one-half of the deaths attributed to cardiovascular-renal deaths (CVR) the information was sketchy. However, in 78% the reported diagnoses were judged to be most probable. For specific diagnoses such as those involving vascular lesions of the central nervous system, the proportion of most probable diagnoses was higher, 85%. A relatively large proportion (15%) of deaths from CVR diseases was certified by the medical examiner or coroner. For coronary heart disease, this proportion was 31%. Medicolegal cases may influence significantly the quality of mortality statistics for diseases of the coronary arteries. Despite criticisms of the quality of diagnostic information which form the base for CVR mortality statistics, the study in Pennsylvania indicates that the quality of diagnostic information is for the most part reasonably good or better, and that diagnostic information is completely reported with relatively high precision. Although there are limitations to the use of mortality data relating to the specific components of CVR diseases, statistics for the total complex of CVR diseases appear reliable for interpretation of mortality trends.