Stehbens W E
Lancet. 1987 Mar 14;1(8533):606-11. doi: 10.1016/s0140-6736(87)90243-1.
Epidemiologists have used mortality statistics to demonstrate a sharp rise in the incidence of coronary heart disease in several countries since the turn of the century and a decline in some countries since the late 1960s. However, increased longevity, changes in coding and diagnostic practices, and familiarity with the clinical and pathological features of the disease make the increase largely spurious. Diagnostic errors in certified causes of death in general, and coronary heart disease in particular, indicate that vital statistics are too unreliable for determining whether there has been an increase and a subsequent decline in the incidence of coronary heart disease.
流行病学家利用死亡率统计数据表明，自世纪之交以来，几个国家冠心病的发病率急剧上升，而自20世纪60年代末以来，一些国家的发病率有所下降。然而，寿命延长、编码和诊断方法的变化以及对该疾病临床和病理特征的熟悉，使得这种上升在很大程度上是虚假的。一般死亡证明原因中的诊断错误，尤其是冠心病的诊断错误，表明生命统计数据对于确定冠心病发病率是否先上升后下降过于不可靠。
