Predictive value of death certification in the case ascertainment of epilepsy.
OBJECTIVE
Death certificates are an unreliable source of information on cause of death, and mortality due to epilepsy can thus be underestimated.


METHODS
We investigated people with epilepsy who had died, and attempted to identify factors that influence inclusion of epilepsy on the death certificate; eight factors were hypothesised and entered into a univariate logistic regression model.


RESULTS
Epilepsy was on the death certificate of 16/243 (7%) people who had had epilepsy. Factors that influenced whether or not epilepsy appeared on the certificate were seizure frequency, antiepileptic drug treatment, cause of death, and certifying physician. Factors that did not seem to influence the inclusion of epilepsy were presence of convulsive seizures, occurrence of seizures during follow up, and age at death.


CONCLUSIONS
We have estimated the degree of unreliability of death certificates (as currently used in the UK) as a source of information on cause of death in epilepsy. We have found that epilepsy may not appear on death certificates even if people had active epilepsy.
Bell
G S
GS
Neuroepidemiology Unit, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, WC1N 3BG, UK.
Gaitatzis
A
A
Johnson
A L
AL
Sander
J W
JW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D016021:Epidemiologic Studies; D004827:Epilepsy / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D015203:Reproducibility of Results; D006113:United Kingdom