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February 12, 1982, Vol 247, No. 6 >
ARTICLE | February 12, 1982

Mortality Data Analysis Using a Multiple-Cause Approach FREE

Richard A. Goodman, MD; Kenneth G. Manton, PhD; Timothy F. Nolan, Jr, MD; Dennis J. Bregman, MS; Alan R. Hinman, MD, MPH
[+] Author Affiliations

Reprint requests to Centers for Disease Control, Technical Information Services, Atlanta, GA 30333 (Dr Hinman).


JAMA. 1982;247(6):793-796. doi:10.1001/jama.1982.03320310041026
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References

Death certificates are the primary source for information used to define general mortality patterns in the United States. Analyses of mortality data generally are restricted to one of the conditions listed on the certificate— the underlying cause of death. We review principles related to the use of mortality data and describe a study using mortality tapes ("multiple-cause tapes") that list all conditions recorded on death certificates. Using multiple-cause tapes, we found that the number of deaths associated with seven infectious diseases in 1968, 1969, and 1970 was from 24% (diphtheria) to 81% (rubella) greater than that officially reported. Multiple-cause tapes also permitted a review of the association of deaths attributed to measles and varicella and known complications of these diseases. These observations confirm the usefulness of multiple-cause tapes in analyzing mortality data and emphasize the importance of examining all conditions listed on the death certificate.

(JAMA 1982;247:793-796)

REFERENCES

1 +
Physician's Handbook on Medical Certification: Death, Birth, Fetal Death , National Center for Health Statistics. US Dept of Health, Education, and Welfare publication No. (PHS) 78-1108, 1978;.
2 +
Britton M:  Clinical diagnostics: Experience from 383 autopsied cases . Acta Med Scand 1974;;196:211-219.
3 +
Feinstein AR:  Clinical epidemiology: II. The identification rates of disease . Ann Intern Med 1968;;69:1037-1061.
4 +
Holler JW, DeMorgan NP:  A retrospective study of 200 post-mortem examinations . J Med Educ 1970;;45:168-170.
5 +
Prutting J:  Lack of correlation between antemortem and postmortem diagnoses . NY State J Med 1967;;67:2081-2084.
6 +
Rosenberg H:  National multiple cause of death statistics . Presented at the 17th biennial meeting of the Public Health Conference on Records and Statistics, Washington, DC, June 5-7, 1978.
7 +
Pitts AM:  Some notes on the collection of US multiple cause of death data with illustrative multiple cause tabulations for 1969 . Presented at Multiple Cause of Death Statistical Data Development Conference, Washington, DC, Nov 9-10, 1976.
8 +
Vital Statistics of the United States, Vol II—Mortality, Part A, 1968 , National Center for Health Statistics. Washington, DC, Health Services and Mental Health Administration, US Dept of Health, Education, and Welfare, 1972;.
9 +
Vital Statistics of the United States, Vol II—Mortality, Part A, 1969 , National Center for Health Statistics. Rockville, Md, Health Services and Mental Health Administration, US Dept of Health, Education, and Welfare, 1974;.
10 +
Vital Statistics of the United States, Vol II—Mortality, Part A, 1970 , National Center for Health Statistics. Rockville, Md, Health Services and Mental Health Administration, US Dept of Health, Education, and Welfare, 1974;.
11 +
Dorn HF, Moriyama IM:  Uses and significance of multiple cause tabulations for mortality statistics . Am J Public Health 1964;;54:400-406.
12 +
Dublin LI, Van Buren GH:  Contributory causes of death—their importance and suggestions for their classification . Am J Public Health 1924;;14:100-105.
13 +
Guralnick L:  Some problems in the use of multiple causes of death . J Chronic Dis 1966;; 19:979.
14 +
James G, Patton RE, Heslin AS:  Accuracy of cause-of-death statements on death certificates . Public Health Rep 1955;;70:39-51.
15 +
Janssen TA:  Importance of tabulating multiple causes of death . Am J Public Health 1940;;30:871-879.
16 +
Wong O, Rockette HE, Redmond CK, et al:  Evaluation of multiple causes of death in occupational mortality studies . J Chronic Dis 1978;; 31:183-193.
17 +
Britton M:  Diagnostic errors discovered at autopsy . Acta Med Scand 1974;;196:203-210.
18 +
Gruver RH, Freis ED:  A study of diagnostic errors . Ann Intern Med 1957;;47:108-120.
19 +
Gwynne JF:  The unreliability of death certificates . NZ Med J 1974;;80:336.
20 +
Lundberg GD, Voigt GE:  Reliability of a presumptive diagnosis in sudden unexpected death in adults: The case for the autopsy . JAMA 1979;;242:2328-2330.
21 +
Moriyama IM, Baum WS, Haenszel WM, et al:  Inquiry into diagnostic evidence supporting medical certification of death . Am J Public Health 1958;;48:1376-1387.
22 +
Pohlen K, Emerson H:  Errors in clinical statements of causes of death . Am J Public Health 1943;;33:505-516.
23 +
Rigdon RH:  Reliability of data from death certificates . N Engl J Med 1980;;303:1422.
24 +
Swartout HO, Webster RG:  To what degree are mortality statistics dependable? Am J Public Health 1940;;30:811-815.
25 +
Speizer FE, Trey C, Parker P:  The uses of multiple causes of death to clarify changing patterns of cirrhosis mortality in Massachusetts . Am J Public Health 1977;;67:333-336.
26 +
Barkin RM:  Measles mortality: Analysis of the primary cause of death . Am J Dis Child 1975;;129:307-309.
27 +
Barkin RM:  Measles mortality: A retrospective look at the vaccine era . Am J Epidemiol 1975;;102:341-349.
28 +
Preblud SR, D'Angelo L:  Chickenpox in the United States, 1972-1977 . J Infect Dis 1979;; 140:257-260.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Physician's Handbook on Medical Certification: Death, Birth, Fetal Death , National Center for Health Statistics. US Dept of Health, Education, and Welfare publication No. (PHS) 78-1108, 1978;.
2 +
Britton M:  Clinical diagnostics: Experience from 383 autopsied cases . Acta Med Scand 1974;;196:211-219.
3 +
Feinstein AR:  Clinical epidemiology: II. The identification rates of disease . Ann Intern Med 1968;;69:1037-1061.
4 +
Holler JW, DeMorgan NP:  A retrospective study of 200 post-mortem examinations . J Med Educ 1970;;45:168-170.
5 +
Prutting J:  Lack of correlation between antemortem and postmortem diagnoses . NY State J Med 1967;;67:2081-2084.
6 +
Rosenberg H:  National multiple cause of death statistics . Presented at the 17th biennial meeting of the Public Health Conference on Records and Statistics, Washington, DC, June 5-7, 1978.
7 +
Pitts AM:  Some notes on the collection of US multiple cause of death data with illustrative multiple cause tabulations for 1969 . Presented at Multiple Cause of Death Statistical Data Development Conference, Washington, DC, Nov 9-10, 1976.
8 +
Vital Statistics of the United States, Vol II—Mortality, Part A, 1968 , National Center for Health Statistics. Washington, DC, Health Services and Mental Health Administration, US Dept of Health, Education, and Welfare, 1972;.
9 +
Vital Statistics of the United States, Vol II—Mortality, Part A, 1969 , National Center for Health Statistics. Rockville, Md, Health Services and Mental Health Administration, US Dept of Health, Education, and Welfare, 1974;.
10 +
Vital Statistics of the United States, Vol II—Mortality, Part A, 1970 , National Center for Health Statistics. Rockville, Md, Health Services and Mental Health Administration, US Dept of Health, Education, and Welfare, 1974;.
11 +
Dorn HF, Moriyama IM:  Uses and significance of multiple cause tabulations for mortality statistics . Am J Public Health 1964;;54:400-406.
12 +
Dublin LI, Van Buren GH:  Contributory causes of death—their importance and suggestions for their classification . Am J Public Health 1924;;14:100-105.
13 +
Guralnick L:  Some problems in the use of multiple causes of death . J Chronic Dis 1966;; 19:979.
14 +
James G, Patton RE, Heslin AS:  Accuracy of cause-of-death statements on death certificates . Public Health Rep 1955;;70:39-51.
15 +
Janssen TA:  Importance of tabulating multiple causes of death . Am J Public Health 1940;;30:871-879.
16 +
Wong O, Rockette HE, Redmond CK, et al:  Evaluation of multiple causes of death in occupational mortality studies . J Chronic Dis 1978;; 31:183-193.
17 +
Britton M:  Diagnostic errors discovered at autopsy . Acta Med Scand 1974;;196:203-210.
18 +
Gruver RH, Freis ED:  A study of diagnostic errors . Ann Intern Med 1957;;47:108-120.
19 +
Gwynne JF:  The unreliability of death certificates . NZ Med J 1974;;80:336.
20 +
Lundberg GD, Voigt GE:  Reliability of a presumptive diagnosis in sudden unexpected death in adults: The case for the autopsy . JAMA 1979;;242:2328-2330.
21 +
Moriyama IM, Baum WS, Haenszel WM, et al:  Inquiry into diagnostic evidence supporting medical certification of death . Am J Public Health 1958;;48:1376-1387.
22 +
Pohlen K, Emerson H:  Errors in clinical statements of causes of death . Am J Public Health 1943;;33:505-516.
23 +
Rigdon RH:  Reliability of data from death certificates . N Engl J Med 1980;;303:1422.
24 +
Swartout HO, Webster RG:  To what degree are mortality statistics dependable? Am J Public Health 1940;;30:811-815.
25 +
Speizer FE, Trey C, Parker P:  The uses of multiple causes of death to clarify changing patterns of cirrhosis mortality in Massachusetts . Am J Public Health 1977;;67:333-336.
26 +
Barkin RM:  Measles mortality: Analysis of the primary cause of death . Am J Dis Child 1975;;129:307-309.
27 +
Barkin RM:  Measles mortality: A retrospective look at the vaccine era . Am J Epidemiol 1975;;102:341-349.
28 +
Preblud SR, D'Angelo L:  Chickenpox in the United States, 1972-1977 . J Infect Dis 1979;; 140:257-260.

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