Validation of death and suicide recording on the THIN UK primary care database.
OBJECTIVE
Data from a cohort study were used to investigate death and cause of death (COD) recording on the THIN UK primary care database.


METHODS
Subjects from 118 practices had a body mass index recorded, 2002-2003 (index date), no recent pregnancy or emotional event, or cancer. Coded and free text entries were searched for a COD for deaths dated < or = 485 days after index date. External documents were requested when date or COD were unclear, suicide was possible, and for a random sample of 40 patients with a COD identified.


RESULTS
Five of 1399 deaths dated within 1 year of the index date had not died (positive predictive value 99.6%) and 4 of 222 dated within 366-485 days had died during the year (sensitivity 99.7%). A database COD was identified for 887 (63.4%) with external documents received for 597 (92.8% requested). Of 40 compared with external sources, the underlying COD was on the database in 33 (82.5%), and could be identified as such in 26 (65%). The date was within 1 day of that on external documents in 504 (94.9%) with a date of death but 3 (5.7%) with only a transfer-out of practice date. One of seven suicides was recorded as such.


CONCLUSIONS
Any database record of death or its date is reliable, but transfer-out date is often later. Studies of COD or acute, potentially fatal conditions will miss cases unless a COD is obtained for all fatalities. Most suicides are not noted as such on the electronic record.
Hall
Gillian C
GC
Grimsdyke House, London, UK. gillian_hall@gchall.demon.co.uk
D002423:Cause of Death; D015331:Cohort Studies; D016208:Databases, Factual / Q000592:standards*; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000592:standards*; D011320:Primary Health Care / Q000706:statistics & numerical data; D013405:Suicide / Q000706:statistics & numerical data; D006113:United Kingdom; D054928:Validation Studies as Topic