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Cause of Death

John E. Patterson
JAMA. 1987;258(22):3252. doi:10.1001/jama.1987.03400220052015.
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To the Editor.—  As director of the Division of Vital Statistics in the National Center for Health Statistics, I commend Kircher and Anderson1 on their article discussing the importance of data on cause of death and offering suggestions on how they may be improved. I whole-heartedly concur with their conclusions that better training of physicians in the proper completion of the medical certification of cause of death is essential if we are to improve the quality of these data. The National Center for Health Statistics will continue its efforts to promote training and would welcome suggestions regarding how the training activities proposed in the article could best be implemented.Kircher and Anderson did an excellent job of explaining the medical certification and the proper sequence for entering information about the cause of death. However, they have erred in their instructions for the completion of the death certificate in certain

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