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JAMA. 1935;105(18):1405-1411. doi:10.1001/jama.1935.02760440015005.
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The statement that heart disease is the leading cause of death has become almost axiomatic. Despite the voluminous literature that has been developed regarding heart disease mortality, most of the writers have been uncritical of the sources from which such information is obtained and of current practices in compiling vital statistics. My purpose in this article is to discuss frankly the accuracy with which deaths from cardiac diseases are reported and to appraise present-day methods of computing heart disease mortality statistics. I shall show that the official system of tabulating heart disease mortality is not keeping pace with well established advances in clinical medicine and offer suggestions for improving it.

HOW ACCURATE ARE HEART DISEASE MORTALITY STATISTICS?  To determine the present status of heart disease mortality statistics, a study was made of deaths attributed to heart disease in Washington, D. C., during 1932 by analyzing death certificates filed in a


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