Misclassification of coronary heart disease in mortality statistics. Evidence from the WHO-MONICA Ghent-Charleroi Study in Belgium
Misclassification of coronary heart disease in mortality statistics. Evidence from the WHO-MONICA Ghent-Charleroi Study in Belgium
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DOI：
10.1136/jech.52.8.513
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发表时间：
1998-08-01
影响因子：
6.3
通讯作者：
De Backer, G
中科院分区：
文献类型：
--
作者：
De Henauw, S;de Smet, P;De Backer, G
研究目的--根据WHO-MONICA项目进行的独立急性心肌梗死(AMI)登记，验证比利时冠心病(CHD)的生命统计数据。设计-WHO-MONICA登记中的急性心肌梗死死亡病例记录分别与相应的死亡证明相关联。设置-自1983年以来，世卫组织-莫尼卡合作中心根特/沙勒罗伊登记了两个地理区域25-69岁年龄组的所有致命和非致命急性心肌梗死，根特在说荷兰语的北部地区和查勒罗伊在说法语的南部地区。注册是根据莫尼卡协议完成的。比利时的官方生命统计数据每年公布一次。它们基本上反映了根据《国际疾病分类》(ICD)第9次修订进行编码的“潜在”死因。主要结果：在741例(根特)和934例(沙勒罗伊)死亡的急性心肌梗死患者中，492例(66.4%)和641例(68.6%)被正式标记为冠心病(ICD代码410-414)；438例(59.1%)和385例(41.2%)被正式标记为急性心肌梗死(ICD代码410)。莫尼卡急性心肌梗死患者中有相当一部分被编码为“其他形式的冠心病”(ICD 411-414)或“其他形式的心脏病”(ICD 420-429)，根特和沙勒罗伊分别为27.1%和38.2%。其余的莫尼卡急性心肌梗死病例--根特的13.8%和沙勒罗伊的20.6%--要么被归类为非常特殊的(例如，动脉粥样硬化，ICD 440)，要么被归类为完全不相关的ICD代码(例如，肿瘤，ICD 140-239)。结论-从本文的结果得出的结论--从本文的结果得出的结论--比利时由CHD引起的死亡的很大一部分被贴上了错误的ICD代码的标签，因此在比利时官方的死亡统计数据中被错误地分类。这在一定程度上是由于病例“流失”到与CHD相关的不太具体的ICD类别。然而，有相当一部分似乎绝对被错误归类。
Study objective-To validate the Belgian vital statistics for coronary heart disease (CHD) on the basis of an independent acute myocardial infarction (AMI) register, carried out as part of the WHO-MONICA project.Design-Records of fatal cases of AMI in the WHO-MONICA register were individually linked to the corresponding death certificates.Setting-Since 1983, the WHO-MONICA Collaborating Centre Ghent/Charleroi registers all fatal and non-fatal AMI in the age group 25-69 years in two geographical areas, Ghent in the northern Dutch speaking part and Charleroi in the southern French speaking part of Belgium. Registration is done according to the MONICA protocol. The official vital statistics in Belgium are published on a yearly basis. They are essentially a reflection of the "underlying" causes of death, coded according to the 9th revision of the International Classification of Diseases (ICD). The study was undertaken in the period 1983-1991.Main results-Out of a total of 741 (Ghent) and 934 (Charleroi) well documented MONICA fatal cases of AMI, 492 (66.4%) and 641 (68.6%), respectively, were officially labelled as CHD (ICD code 410-414); 438 (59.1%) and 385 (41.2%), respectively, were officially labelled as AMI (ICD code 410). A substantial fraction of the MONICA AMI cases-27.1% in Ghent and 38.2% in Charleroi-was coded as "other forms of CHD" (ICD 411-414) or as "other forms of heart disease" (ICD 420-429). The remaining MONICA AMI cases-13.8% in Ghent and 20.6% in Charleroi-were classified in either very aspecific (for example, atherosclerosis, ICD 440) or totally unrelated ICD codes (for example, neoplasm, ICD 140-239).Conclusions-It is concluded from the results in this paper that a substantial part of all deaths caused by CHD in Belgium are labelled with incorrect ICD codes and are therefore misclassified in the official mortality statistics for Belgium. This is partly caused by a "drainage" of cases towards less specific CHD related ICD categories. A considerable fraction, however, seems to be absolutely misclassified.