title: Sensitivity and specificity of administrative mortality data for identifying prescription opioid-related deaths.
abstract: BACKGROUND
  Comprehensive systems for surveilling prescription opioid-related harms provide clear evidence that deaths from prescription opioids have increased dramatically in the United States. However, these harms are not systematically monitored in Canada. In light of a growing public health crisis, accessible, nationwide data sources to examine prescription opioid-related harms in Canada are needed. We sought to examine the performance of 5 algorithms to identify prescription opioid-related deaths from vital statistics data against data abstracted from the Office of the Chief Coroner of Ontario as a gold standard.
  
  
  METHODS
  We identified all prescription opioid-related deaths from Ontario coroners' data that occurred between Jan. 31, 2003, and Dec. 31, 2010. We then used 5 different algorithms to identify prescription opioid-related deaths from vital statistics death data in 2010. We selected the algorithm with the highest sensitivity and a positive predictive value of more than 80% as the optimal algorithm for identifying prescription opioid-related deaths.
  
  
  RESULTS
  Four of the 5 algorithms had positive predictive values of more than 80%. The algorithm with the highest sensitivity (75%) in 2010 improved slightly in its predictive performance from 2003 to 2010.
  
  
  CONCLUSIONS
  In the absence of specific systems for monitoring prescription opioid-related deaths in Canada, readily available national vital statistics data can be used to study prescription opioid-related mortality with considerable accuracy. Despite some limitations, these data may facilitate the implementation of national surveillance and monitoring strategies.
authors.affiliation: School of Population and Public Health (Gladstone, Smolina, Morgan), University of British Columbia, Vancouver, BC; Institute for Clinical Evaluative Sciences (Fernandes, Martins, Gomes); Li Ka Shing Knowledge Institute (Gomes), St. Michael's Hospital, Toronto, Ont.
authors.forename: Emilie
authors.initials: E
authors.lastname: Gladstone
authors.affiliation: School of Population and Public Health (Gladstone, Smolina, Morgan), University of British Columbia, Vancouver, BC; Institute for Clinical Evaluative Sciences (Fernandes, Martins, Gomes); Li Ka Shing Knowledge Institute (Gomes), St. Michael's Hospital, Toronto, Ont.
authors.forename: Kate
authors.initials: K
authors.lastname: Smolina
authors.affiliation: School of Population and Public Health (Gladstone, Smolina, Morgan), University of British Columbia, Vancouver, BC; Institute for Clinical Evaluative Sciences (Fernandes, Martins, Gomes); Li Ka Shing Knowledge Institute (Gomes), St. Michael's Hospital, Toronto, Ont.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Morgan
authors.affiliation: School of Population and Public Health (Gladstone, Smolina, Morgan), University of British Columbia, Vancouver, BC; Institute for Clinical Evaluative Sciences (Fernandes, Martins, Gomes); Li Ka Shing Knowledge Institute (Gomes), St. Michael's Hospital, Toronto, Ont.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Fernandes
authors.affiliation: School of Population and Public Health (Gladstone, Smolina, Morgan), University of British Columbia, Vancouver, BC; Institute for Clinical Evaluative Sciences (Fernandes, Martins, Gomes); Li Ka Shing Knowledge Institute (Gomes), St. Michael's Hospital, Toronto, Ont.
authors.forename: Diana
authors.initials: D
authors.lastname: Martins
authors.affiliation: School of Population and Public Health (Gladstone, Smolina, Morgan), University of British Columbia, Vancouver, BC; Institute for Clinical Evaluative Sciences (Fernandes, Martins, Gomes); Li Ka Shing Knowledge Institute (Gomes), St. Michael's Hospital, Toronto, Ont. gomest@smh.ca.
authors.forename: Tara
authors.initials: T
authors.lastname: Gomes
mesh_terms: D000465:Algorithms; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D002170:Canada / Q000453:epidemiology; D062787:Drug Overdose / Q000401:mortality*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006801:Humans; D009864:Ontario / Q000453:epidemiology; D012680:Sensitivity and Specificity; D014798:Vital Statistics
chemical_list: D000701:Analgesics, Opioid