Deaths from heart failure: using coarsened exact matching to correct cause-of-death statistics.

Deaths from heart failure: using coarsened exact matching to correct cause-of-death statistics.
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DOI:
10.1186/1478-7954-8-6
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发表时间:
2010-04-13
影响因子:
3.3
通讯作者:
Shibuya K
Shibuya K
中科院分区:
医学2区
文献类型:
--
作者:
Stevens GA;King G;Shibuya K

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死亡证明上的信息不完整,使得有记录的死亡原因数据对公共卫生监测和规划用处不大。认证医生有时只列出死亡方式,而不说明导致死亡的潜在疾病。心血管死亡原因之间的死因分配不一致尤其令人关切。这可能会妨碍各国之间和一段时间内进行有效的流行病学比较。我们建议,粗精确匹配被用来推断死亡的根本原因,只有死亡模式是已知的。我们关注美国、墨西哥和巴西的心力衰竭死亡记录。使用这种方法得出的再分布算法将所有三个国家中最大比例的心力衰竭死亡分配给缺血性心脏病(分别为53%,26%和22%),墨西哥和巴西的高血压心脏病和糖尿病比例更大(高血压心脏病为16%和23% vs. 7%,糖尿病为13%和9% vs. 6%)。重新分配这些心力衰竭死亡使美国缺血性心脏病死亡率增加6%。医生在各种潜在死亡原因的因果链中列出心力衰竭的频率允许推断医生如何在不同环境中在死亡证明上使用心力衰竭。这种易于使用的方法有可能减少偏差,增加死因数据的可比性,从而提高死亡记录的公共卫生效用。
Incomplete information on death certificates makes recorded cause-of-death data less useful for public health monitoring and planning. Certifying physicians sometimes list only the mode of death without indicating the underlying disease or diseases that led to the death. Inconsistent cause-of-death assignment among cardiovascular causes of death is of particular concern. This can prevent valid epidemiologic comparisons across countries and over time. We propose that coarsened exact matching be used to infer the underlying causes of death where only the mode of death is known. We focus on the case of heart failure in US, Mexican, and Brazilian death records. Redistribution algorithms derived using this method assign the largest proportion of heart failure deaths to ischemic heart disease in all three countries (53%, 26%, and 22% respectively), with larger proportions assigned to hypertensive heart disease and diabetes in Mexico and Brazil (16% and 23% vs. 7% for hypertensive heart disease, and 13% and 9% vs. 6% for diabetes). Reassigning these heart failure deaths increases the US ischemic heart disease mortality rate by 6%. The frequency with which physicians list heart failure in the causal chain for various underlying causes of death allows for inference about how physicians use heart failure on the death certificate in different settings. This easy-to-use method has the potential to reduce bias and increase comparability in cause-of-death data, thereby improving the public health utility of death records.
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