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The accuracy of death certification of respiratory disease in france and 7 other countries of the european economic community



The accuracy of death certification of respiratory disease in france and 7 other countries of the european economic community



Revue des Maladies Respiratoires 1(6): 361-368



A recent study of mortality due to respiratory disease, carried out in the member countries of the European Economic Community (EEC) showed different levels of mortality between the countries. To establish whether these variations in mortality were real or due to methods of filing and coding, a study of death certification was carried out in each country based on 10 common clinical diagnostic categories to assess overall accuracy. In France, 75 doctors picked at random, were asked to fill in a form for each observation as though it were a real death. The cause of death was coded by the usual national center and re-coded by a reference center in London. The protocol was similar for each country taking part. Important differences were found between and within each country. Some arise from the way in which doctors write out the death certificates (an excess of deaths from other disease of the respiratory tract in France and from cardiovascular diseases in Italy), in others the way of coding was due to (an excess of deaths by other disease of the respiratory tract in Belgium). The degree of concordance depends on the complexity of the case (possible interaction of several pathologies), particular national characteristics, and whether account of these is made by the medical profession. These divergences can in part explain the different mortality statistics from respiratory disease between countries of the EEC. Later on it will be necessary to make the wording and the coding of the death certificate more standardized within the EEC.

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