2008-2013 年纽约市军团病导致死亡病例的死亡证明数据的敏感性和阳性预测值。

Sensitivity and Positive Predictive Value of Death Certificate Data Among Deaths Caused by Legionnaires' Disease in New York City, 2008-2013.

机构信息

1 Division of Disease Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA.

2 Clinical Research and Development, Evolent Health, Arlington, VA, USA.

出版信息

Public Health Rep. 2018 Sep/Oct;133(5):578-583. doi: 10.1177/0033354918782494. Epub 2018 Jul 13.

DOI:10.1177/0033354918782494

PMID:30005174

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6134557/

Abstract

OBJECTIVES

Death certificates are an important source of information for understanding life expectancy and mortality trends; however, misclassification and incompleteness are common. Although deaths caused by Legionnaires' disease might be identified through routine surveillance, it is unclear whether Legionnaires' disease is accurately recorded on death certificates. We evaluated the sensitivity and positive predictive value of death certificates for identifying deaths from confirmed or suspected Legionnaires' disease among adults in New York City.

METHODS

We deterministically matched death certificate data from January 1, 2008, through December 31, 2013, on New York City residents aged ≥18 years to surveillance data on confirmed and suspected cases of Legionnaires' disease from January 1, 2008, through October 31, 2013. We estimated sensitivity and positive predictive value by using surveillance data as the reference standard.

RESULTS

Of 294 755 deaths, 27 (<0.01%) had an underlying cause of death of Legionnaires' disease and 33 (0.01%) had any mention of Legionnaires' disease on the death certificate. Of 1211 confirmed or suspected cases of Legionnaires' disease, 267 (22.0%) matched to a record in the death certificate data set. The sensitivity of death certificates that listed Legionnaires' disease as the underlying cause of death was 17.3% and of death certificates with any mention of Legionnaires' disease was 20.9%. The positive predictive value of death certificates that listed Legionnaires' disease as the underlying cause of death was 70.4% and of death certificates with any mention of Legionnaires' disease was 69.7%.

CONCLUSIONS

Death certificates had limited ability to identify confirmed or suspected deaths with Legionnaires' disease. Provider trainings on the diagnosis of Legionnaires' disease, particularly hospital settings, and proper completion of death certificates might improve the sensitivity of death certificates for people who die of Legionnaires' disease.

摘要

目的

死亡证明是了解预期寿命和死亡率趋势的重要信息来源；然而，错误分类和不完整的情况很常见。虽然通过常规监测可以识别军团病引起的死亡，但军团病是否准确记录在死亡证明上尚不清楚。我们评估了死亡证明在识别纽约市成年患者确诊或疑似军团病死亡方面的敏感性和阳性预测值。

方法

我们通过确定性方法匹配了 2008 年 1 月 1 日至 2013 年 12 月 31 日期间纽约市≥18 岁居民的死亡证明数据和 2008 年 1 月 1 日至 2013 年 10 月 31 日期间的军团病确诊和疑似病例监测数据。我们使用监测数据作为参考标准来估计敏感性和阳性预测值。

结果

在 294755 例死亡中，有 27 例（<0.01%）的根本死因是军团病，33 例（0.01%）的死亡证明上有军团病的任何记载。在 1211 例确诊或疑似军团病病例中，有 267 例（22.0%）与死亡证明数据集的记录相匹配。将军团病列为根本死因的死亡证明的敏感性为 17.3%，任何提到军团病的死亡证明的敏感性为 20.9%。将军团病列为根本死因的死亡证明的阳性预测值为 70.4%，任何提到军团病的死亡证明的阳性预测值为 69.7%。