Accuracy and completeness of mortality data in the Department of Veterans Affairs.
Accuracy and completeness of mortality data in the Department of Veterans Affairs.
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DOI：
10.1186/1478-7954-4-2
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发表时间：
2006-04-10
影响因子：
3.3
通讯作者：
Hynes DM
中科院分区：
文献类型：
--
作者：
Sohn MW;Arnold N;Maynard C;Hynes DM
美国的国家死亡率数据库之一是受益人识别和记录子系统（BIRLS）死亡文件，其中包含从退伍军人事务部（VA）获得任何福利的人的死亡日期。在先前的研究中，该数据库的完整性在队列与队列之间存在很大差异。其他三个来源的死亡日期可在VA，可以补充BIRLS死亡文件。本研究的目的是评估VA中四个来源的死亡日期的完整性和准确性，并检查这四个来源是否可以合并到一个数据库中，以提高完整性和准确性。根据至少一个消息来源，从1997年至1999年期间从退伍军人管理局获得福利并于1999年1月1日活着的830万退伍军人中随机抽取了3,000人。将BIRLS死亡档案、医疗SAS住院患者数据集、医疗保险生命状态和社会保障管理局（SSA）死亡主档案中发现的死亡日期与国家死亡指数中获得的日期进行比较。来自这些来源的综合数据集也与国家死亡指数日期进行了比较。与国家死亡指数相比，BIRLS死亡文件的敏感性（或在源中正确记录的死亡日期的百分比）为77.4%，医疗SAS住院患者数据集为12.0%，医疗保险生命状态为83.2%，SSA死亡主文件为92.1%。这些来源中超过95%的死亡日期与国家死亡指数的日期完全一致。合并数据集中的死亡日期与国家死亡指数的日期显示出98.3%的敏感性和97.6%的准确一致性。由于不完整，BIRLS死亡文件不是VA人群死亡率数据的适当来源。当这四个来源的死亡率数据仔细结合起来，所产生的数据集可以提供更及时的数据，死亡确定比国家死亡指数，并具有可比的准确性和完整性。
One of the national mortality databases in the U.S. is the Beneficiary Identification and Record Locator Subsystem (BIRLS) Death File that contains death dates of those who have received any benefits from the Department of Veterans Affairs (VA). The completeness of this database was shown to vary widely from cohort to cohort in previous studies. Three other sources of death dates are available in the VA that can complement the BIRLS Death File. The objective of this study is to evaluate the completeness and accuracy of death dates in the four sources available in the VA and to examine whether these four sources can be combined into a database with improved completeness and accuracy. A random sample of 3,000 was drawn from 8.3 million veterans who received benefits from the VA between 1997 and 1999 and were alive on January 1, 1999 according to at least one source. Death dates found in BIRLS Death File, Medical SAS Inpatient Datasets, Medicare Vital Status, and Social Security Administration (SSA) Death Master File were compared with dates obtained from the National Death Index. A combined dataset from these sources was also compared with National Death Index dates. Compared with the National Death Index, sensitivity (or the percentage of death dates correctly recorded in a source) was 77.4% for BIRLS Death File, 12.0% for Medical SAS Inpatient Datasets, 83.2% for Medicare Vital Status, and 92.1% for SSA Death Master File. Over 95% of death dates in these sources agreed exactly with dates from the National Death Index. Death dates in the combined dataset demonstrated 98.3% sensitivity and 97.6% exact agreement with dates from the National Death Index. The BIRLS Death File is not an adequate source of mortality data for the VA population due to incompleteness. When the four sources of mortality data are carefully combined, the resulting dataset can provide more timely data for death ascertainment than the National Death Index and has comparable accuracy and completeness.