Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Epidemiology. 2011 Jul;22(4):516-23. doi: 10.1097/EDE.0b013e31821b5332.
The Coding Causes of Death in HIV (CoDe) Project aims to deliver a standardized method for coding the underlying cause of death in HIV-positive persons, suitable for clinical trials and epidemiologic studies.
The project incorporates detailed data collection, a classification system, and a centralized adjudication process performed by 2 independent reviewers. The methodology was tested in the Data Collection on Adverse events of Anti-HIV Drugs Study , and independent reviews of causes of death were compared. Logistic regression models identified factors associated with initial agreement by reviewers on underlying cause of death.
A total of 491 reported fatal cases were adjudicated; in only 5% of cases the cause of death remained undetermined after adjudication. Reviewers initially agreed on the underlying cause for 339 (69%) deaths. As compared with deaths due to AIDS-related causes, the odds of agreement were more than 80% lower when deaths were ultimately deemed to be due to non-AIDS-related causes (odds ratio = 0.17 [95% confidence interval = 0.08-0.37]) or undetermined causes (0.11 [0.04-0.36]). The odds of initial agreement were also lower for deaths occurring in subjects with hypertension (0.43 [0.22-0.85]) and depression (0.43 [0.23-0.80]).
The extent and format of data collected in the CoDe Project appear to be sufficient for an informed review, and the proposed coding scheme is adequate for obtaining an underlying cause of death.
HIV 编码死因（CoDe）项目旨在提供一种适用于临床试验和流行病学研究的标准化方法，用于对 HIV 阳性患者的死亡根本原因进行编码。
该项目结合了详细的数据收集、分类系统和由 2 位独立评审员进行的集中裁决过程。该方法在抗 HIV 药物不良事件数据收集研究中进行了测试，并对死因进行了独立审查。逻辑回归模型确定了与评审员对死亡根本原因的初始一致意见相关的因素。
共对 491 例报告的致命病例进行了裁决；只有 5%的病例在裁决后死因仍未确定。评审员最初对 339 例（69%）死亡的根本原因达成一致。与因艾滋病相关原因导致的死亡相比，最终被认为是非艾滋病相关原因（比值比=0.17[95%置信区间=0.08-0.37]）或未确定原因（0.11[0.04-0.36]）导致的死亡，其一致的可能性降低了 80%以上。对于高血压（0.43[0.22-0.85]）和抑郁（0.43[0.23-0.80]）患者的死亡，初始一致的可能性也较低。
在 CoDe 项目中收集的数据的范围和格式似乎足以进行知情审查，并且所提出的编码方案足以确定死亡的根本原因。
