Changes in certification of diabetes with cardiovascular diseases increased reported diabetes mortality in Australia and the United States

Adair, Timothy and Rao, Chalapati (2010) Changes in certification of diabetes with cardiovascular diseases increased reported diabetes mortality in Australia and the United States. Journal of Clinical Epidemiology, 63 2: 199-204. doi:10.1016/j.jclinepi.2009.04.002


Author Adair, Timothy
Rao, Chalapati
Title Changes in certification of diabetes with cardiovascular diseases increased reported diabetes mortality in Australia and the United States
Journal name Journal of Clinical Epidemiology   Check publisher's open access policy
ISSN 0895-4356
1878-5921
Publication date 2010-02-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.jclinepi.2009.04.002
Volume 63
Issue 2
Start page 199
End page 204
Total pages 6
Place of publication Philadelphia, PA, U.S.A.
Publisher Elsevier
Collection year 2011
Language eng
Abstract Objective: This paper seeks to better understand diabetes-related mortality in Australia and the United States through analysis of the impact of certification practices of diabetes as a multiple cause of death, specifically with cardiovascular diseases (CVDs). Study Design and Setting: Vital registration multiple cause of death data in Australia and the United States since 1999 are used to examine trends in the ratio of diabetes reported in Part I (underlying cause) and Part II (associated cause) of the death certificate, when CVDs are also reported. Results: Underlying cause of death (UCOD) statistics mask the magnitude of diabetes-related mortality. In both countries, since 1999 there has been an increase in the ratio of diabetes deaths in Part I vs. Part II where CVD deaths, including ischemic heart disease and cerebrovascular diseases, are also reported. In Australia, diabetes reported as an UCOD would be 12% lower in 2006 if the ratio from 1999 was applied. Conclusion: The increasing likelihood of physicians to report diabetes in Part I reflects the subjectivity of diabetes death certification. There is a need for specific guidelines on death certification of diabetes with cardiovascular conditions, relating to its reporting as an underlying or associated cause. © 2010 Elsevier Inc. All rights reserved.
Keyword Diabetes
Cardiovascular diseases
Ischemic heart disease
Cerebrovascular diseases
Multiple causes of death
Death certification
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 6 August 2009.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
 
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Created: Sun, 14 Feb 2010, 10:01:53 EST