title: Validity of the European short list of respiratory diseases: a 40-year autopsy study.
abstract: The predictors of autopsy and the accuracy of European short list (E) codes of respiratory diseases lack recent knowledge. A 10% random sample (n=6811) of inhabitants of Bergen, Norway, aged 20-70 years, was invited to participate in a survey in 1965-1971 (participation rate 83%). By December 31, 2005, 4387 (64%) participants had died and 1163 (27% of the deceased) had been given an autopsy. Causes of death were tuberculosis (E02, 0.2%), lung malignancy (E15, 3.5%), influenza (E38, 0.2%), pneumonia (E39, 6.5%) and chronic lower respiratory diseases (E40, 3.2%). Male sex, early deaths in the surveillance period and E15 were positive predictors of an autopsy examination, whereas old age and E39 were strong negative predictors. Among those referred for a post mortem examination, the cause of death was verified as tuberculosis in 0.3%, lung cancer in 8.1%, acute pneumonia in 2.0% and chronic obstructive lung diseases in 4.9%. Cohen's kappa coefficients (E codes versus autopsy) were 0.91 (95% CI 0.86-0.96) for E15, 0.37 (95% CI 0.20-0.54) for E39 and 0.65 (95% CI 0.54-0.76) for E40. These findings matter when deaths from respiratory diseases are used as end-points in epidemiological association studies and clinical trials.
authors.affiliation: Medical Dept, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Gulsvik
authors.affiliation: Section of Thoracic Medicine, Dept of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Henriksen
authors.affiliation: Dept of Pathology, The Gade Institute, Haukeland University Hospital, University of Bergen, Bergen, Norway.
authors.forename: Einar
authors.initials: E
authors.lastname: Svendsen
authors.affiliation: Clinic of Allergology and Respiratory Medicine, Oslo, Norway.
authors.forename: Sjur
authors.initials: S
authors.lastname: Humerfelt
authors.affiliation: Section of Thoracic Medicine, Dept of Clinical Science, University of Bergen, Bergen, Norway amund.gulsvik@med.uib.no.
authors.forename: Amund
authors.initials: A
authors.lastname: Gulsvik
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001344:Autopsy; D002423:Cause of Death; D016001:Confidence Intervals; D016208:Databases, Factual; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009664:Norway; D011237:Predictive Value of Tests; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D014505:Urban Population; D055815:Young Adult