title: Accuracy of death certificates in COPD: analysis from the TORCH trial.
abstract: The Towards a Revolution in COPD Health (TORCH) trial was an international clinical trial of chronic obstructive pulmonary disease (COPD) patients where cause of death was assigned by an independent committee. Comparison of death certificate data and adjudicated cause of death allows a unique opportunity to determine death certificate accuracy and frequency of COPD listing on death certificates of COPD patients. In this analysis, the authors determine the concordance between adjudicated cause of death and primary and secondary cause of death from death certificates. In 317 (80%) of informative deaths, the primary or secondary cause of death from certificates agreed with adjudicated cause of death. Only 229 (58%) of death certificates in these COPD patients listed COPD on the certificate. COPD was not listed on the death certificate in 21% of deaths adjudicated to be caused by COPD exacerbation. Compared with pulmonary causes, the listing of COPD on certificates occurred with less frequency than cardiovascular, cancer and other categories of death. The combined primary and secondary listing on death certificates has good concordance with actual cause of death. COPD is under-reported on death certificates, and this under-reporting is more frequent when the primary cause of death is not pulmonary.
authors.affiliation: Johns Hopkins University School of Medicine, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. mdrummo3@jhmi.edu
authors.forename: M Bradley
authors.initials: MB
authors.lastname: Drummond
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wise
authors.forename: Matthias
authors.initials: M
authors.lastname: John
authors.forename: Michael T
authors.initials: MT
authors.lastname: Zvarich
authors.forename: Lorcan P
authors.initials: LP
authors.lastname: McGarvey
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives; D000730:Androstadienes / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002423:Cause of Death / Q000639:trends; D003627:Data Interpretation, Statistical; D003644:Death Certificates; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000401:mortality*; D000068299:Salmeterol Xinafoate
chemical_list: D000730:Androstadienes; D001993:Bronchodilator Agents; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D000420:Albuterol