Department of Psychoanalysis and Psychotherapy, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Department of Psychiatry, University of British Columbia, Vancouver, Canada.
Eur J Epidemiol. 2024 Oct;39(10):1109-1126. doi: 10.1007/s10654-024-01142-4. Epub 2024 Jul 24.
Mortality statistics are critical to determine the burden of disease. Certain causes of death are prone to being misclassified on cause of death certificates. This poses a serious risk for public health and safety, as accurate death certificates form the basis for mortality statistics, which in turn are crucial for research, funding allocation and health interventions. This study uses generalised estimating equations and regression modelling to investigate for which cause of death categories suicide and accident deaths are misclassified as. National mortality statistics and autopsy rates from North America and Europe covering the past forty years were analysed to determine the associations between the different causes of death in cross-sectional and longitudinal models. We find that suicides and deaths by accidents are frequently mutually misclassified. We also find that suicides are frequently misclassified as drug use disorder deaths, in contrast to accident deaths, which are not misclassified as drug use disorder deaths. Furthermore, suicides do not seem to be misclassified as undetermined deaths or ill-defined deaths. The frequency of misclassification shows that the quality of death certificates should be improved, and autopsies may be used systematically to control the quality of death certificates.
死亡率统计对于确定疾病负担至关重要。某些死因在死亡证明上可能容易被错误分类。这对公共卫生和安全构成了严重威胁，因为准确的死亡证明是死亡率统计的基础，而死亡率统计又是研究、资金分配和卫生干预的关键。本研究使用广义估计方程和回归模型来研究自杀和意外死亡在哪些死因类别中被错误分类。分析了过去四十年来自北美和欧洲的国家死亡率统计数据和尸检率，以确定在横断面和纵向模型中不同死因之间的关联。我们发现自杀和意外死亡经常被相互错误分类。我们还发现，自杀经常被错误地归类为药物使用障碍死亡，而意外死亡则没有被错误地归类为药物使用障碍死亡。此外，自杀似乎没有被错误地归类为未确定死因或不明原因死亡。错误分类的频率表明，死亡证明的质量应得到提高，并且可以系统地使用尸检来控制死亡证明的质量。
