Chamblee R F, Evans M C
Am J Public Health. 1982 Nov;72(11):1265-70. doi: 10.2105/ajph.72.11.1265.
This article discusses the limitations of traditional national cause of death statistics. These limitations derive from an attempt to conceptualize a multidimensional phenomenon and reduce down to a unidimensional framework. The article outlines the characteristics of a new multidimensional approach which involves the codification and tabulation of all causes (multiple causes) listed on death certificates. Preliminary data are presented which illustrate that multiple cause of death data do indeed represent a major new dimension to cause of death statistics. These data indicate that most major causes of death are contributory factors in many deaths in which they are not the underlying cause of death. For example, in 1976, diabetes mellitus was the underlying cause of approximately 35,000 deaths but was a contributing factor in another 100,000 deaths. This paper also demonstrates the contribution of multiple cause of death data to identifying patterns of association among diseases and the kinds of injuries resulting from various external causes. Finally, data are presented which depict the use of multiple cause data in evaluating the efficacy of the coding rules used to classify the underlying cause of death.
本文讨论了传统国家死因统计的局限性。这些局限性源于试图将一个多维度现象概念化并简化为一个单维度框架。本文概述了一种新的多维度方法的特点，该方法涉及对死亡证明上列出的所有死因（多种死因）进行编码和制表。文中给出的初步数据表明，多死因数据确实代表了死因统计的一个重要新维度。这些数据表明，大多数主要死因在许多并非以其为根本死因的死亡中是促成因素。例如，1976年，糖尿病是约35000例死亡的根本死因，但在另外100000例死亡中是促成因素。本文还展示了多死因数据在识别疾病之间的关联模式以及各种外部原因导致的伤害类型方面的作用。最后，给出的数据描述了多死因数据在评估用于分类根本死因的编码规则的有效性方面的应用。
