Deaths from heart failure: using coarsened exact matching to correct cause-of-death statistics.
BACKGROUND
Incomplete information on death certificates makes recorded cause-of-death data less useful for public health monitoring and planning. Certifying physicians sometimes list only the mode of death without indicating the underlying disease or diseases that led to the death. Inconsistent cause-of-death assignment among cardiovascular causes of death is of particular concern. This can prevent valid epidemiologic comparisons across countries and over time.


METHODS
We propose that coarsened exact matching be used to infer the underlying causes of death where only the mode of death is known. We focus on the case of heart failure in US, Mexican, and Brazilian death records.


RESULTS
Redistribution algorithms derived using this method assign the largest proportion of heart failure deaths to ischemic heart disease in all three countries (53%, 26%, and 22% respectively), with larger proportions assigned to hypertensive heart disease and diabetes in Mexico and Brazil (16% and 23% vs. 7% for hypertensive heart disease, and 13% and 9% vs. 6% for diabetes). Reassigning these heart failure deaths increases the US ischemic heart disease mortality rate by 6%.


CONCLUSIONS
The frequency with which physicians list heart failure in the causal chain for various underlying causes of death allows for inference about how physicians use heart failure on the death certificate in different settings. This easy-to-use method has the potential to reduce bias and increase comparability in cause-of-death data, thereby improving the public health utility of death records.
Stevens
Gretchen A
GA
Information, Evidence and Research, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland. stevensg@who.int.
King
Gary
G
Shibuya
Kenji
K
Lancet. 2007 Nov 10;370(9599):1653-63
18029006
Histopathology. 2005 Dec;47(6):551-9
16324191
Lancet. 2009 Mar 14;373(9667):941-55
19286093
Arch Intern Med. 2001 Jan 22;161(2):277-84
11176744
J Clin Epidemiol. 2009 Nov;62(11):1202-9
19364635
J Epidemiol Community Health. 2003 Jun;57(6):470-1
12775799
Circulation. 2006 May 2;113(17):2071-81
16636170
Lancet. 2006 May 27;367(9524):1747-57
16731270
South Med J. 2006 Jul;99(7):728-33
16866055
Diabetes Care. 2008 Mar;31(3):451-8
17959860
Arch Intern Med. 2001 Apr 9;161(7):996-1002
11295963
Jpn Circ J. 1997 Apr;61(4):331-8
9152785
JAMA. 1993 Jun 9;269(22):2850
8123071