Kircher T
Department of Pathology, Penrose Hospital, Colorado Springs, CO.
Hum Pathol. 1990 Feb;21(2):166-73. doi: 10.1016/0046-8177(90)90125-o.
Vital statistics in the United States are collected through a decentralized, cooperative system of various levels of government administrated by the National Center for Health Statistics. Although registration of all deaths is virtually complete and demographic items are accurate, the reliability of cause of death data is hampered by the current state of medical knowledge, the incompleteness of information available at the time of death, the way in which physicians complete death certificates, and the system of classification of underlying cause. The need for quality assurance in national cause of death statistics can be met in large part by connecting the autopsy to the mainstream of vital statistics. Through case by case individual linkage of death certificates and autopsies in designated demographic and/or geographic areas, a representative, continuously collected, population-based system of aggregated autopsy data would be created. Demographic and clinical selection bias should be checked and adjusted through traditional methods of epidemiologic standardization. Such a use of autopsy information could further pathology's goals of understanding disease and improving the public health.
美国的人口统计数据是通过一个由国家卫生统计中心管理的、各级政府分散合作的系统收集的。尽管所有死亡登记几乎完整，人口统计项目准确，但死亡原因数据的可靠性受到当前医学知识水平、死亡时可用信息的不完整性、医生填写死亡证明的方式以及根本死因分类系统的影响。通过将尸检与人口统计的主流联系起来，很大程度上可以满足国家死亡原因统计中对质量保证的需求。通过在指定的人口和/或地理区域对死亡证明和尸检进行逐案个体关联，将创建一个具有代表性的、持续收集的、基于人群的汇总尸检数据系统。应通过传统的流行病学标准化方法检查和调整人口统计学和临床选择偏倚。这种对尸检信息的使用可以进一步实现病理学了解疾病和改善公众健康的目标。
