title: Changes in and Impact of the Death Review Process in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.
abstract: Death review was conducted for the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial to avoid the biases associated with causes of death entered on death certificates. An algorithm selected deaths for review. Records on diagnosis and terminal illness were perused in the coordinating center and by the chair of the death review committee (DRC). Identifying information and randomization arm was removed. Three reviewers independently determined the cause of death. Disagreement was resolved at a meeting of the DRC. This process was subsequently simplified. The cause of death was determined by one DRC member and compared to the death certificate. With agreement the case was finalized. When discordant, the records were sent to a second DRC member. If the reviewers agreed, the case was finalized. If not, a third member reviewed. If two of the three reviewers agreed, the case was sent back to the discordant reviewer. If the reviewer remained discordant the case was resolved by a conference call. Of the 4728 death reviews that were completed, the DRC confirmed the death certificate underlying cause for over 90%. Between 5% and 13% of the certified deaths were regarded as indirect causes of death, associated with the treatment of the ascertained cancer; differential for prostate cancer, 11% in the intervention arm and 6% in the control. Without review, between 1% and 6% of the deaths that occurred would not have been assigned to the relevant PLCO cancer. The DRC completed 76% of those requiring review before the process ceased.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada. ab.miller@sympatico.ca.
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Miller
authors.forename: Ronald
authors.initials: R
authors.lastname: Feld
authors.forename: Robert
authors.initials: R
authors.lastname: Fontana
authors.forename: John K
authors.initials: JK
authors.lastname: Gohagan
authors.forename: Ismail
authors.initials: I
authors.lastname: Jatoi
authors.forename: Walter
authors.initials: W
authors.lastname: Lawrence
authors.forename: Amy
authors.initials: A
authors.lastname: Miller
authors.forename: Philip C
authors.initials: PC
authors.lastname: ProroK
authors.forename: Ashwani
authors.initials: A
authors.lastname: Rajput
authors.forename: Morris
authors.initials: M
authors.lastname: Sherman
authors.forename: Gilbert
authors.initials: G
authors.lastname: Welch
authors.forename: Patrick
authors.initials: P
authors.lastname: Wright
authors.forename: Susan
authors.initials: S
authors.lastname: Yurgalevitch
authors.forename: Peter
authors.initials: P
authors.lastname: Albertsen
mesh_terms: D000465:Algorithms; D002423:Cause of Death / Q000639:trends*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality; D008297:Male; D015337:Multicenter Studies as Topic; D009369:Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000401:mortality; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000401:mortality; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis