Original article
Accuracy of diagnosis on death certificates for underlying causes of death in a long-term autopsy-based population study in Hisayama, Japan; with special reference to cardiovascular diseases

https://doi.org/10.1016/0895-4356(89)90154-6Get rights and content

Abstract

Major categorical diagnosis by International Classification of Diseases and type-specific diagnosis for cardiovascular diseases in death certificates were compared to the diagnosis made at autopsy in 864 consecutive autopsy cases aged 20 or over, among the Japanese residents in Hisayama town. Cerebral stroke was correctly diagnosed in 84%, malignant neoplasms in 78% and cardiac disease in 66%. Cerebral stroke and cardiac disease tended to be overdiagnosed, while malignant neoplasms were underdiagnosed. The validation of certified diagnosis was less reliable in the aged population, and in type-specific diagnosis of cardiovascular diseases. Cerebral hemorrhage with false negative or false positive diagnoses was usually classified into type unspecified stroke or different categories of cerebral stroke, while those misdiagnosed as cases of cerebral infarction frequently had no significant lesions in the autopsied brain. Finally, the relationship between the validation of diagnosis on the death certificates and the secular trend in cardiovascular disease in the Japanese vital statistics was discussed.

References (20)

There are more references available in the full text version of this article.

Cited by (83)

  • Similarities and differences between coronary heart disease and stroke in the associations with cardiovascular risk factors: The Japan Collaborative Cohort Study

    2017, Atherosclerosis
    Citation Excerpt :

    The cause-specific mortality was adjusted for the transition to the International Classification of Diseases (10th revision), and was determined for CHD (I20–I25), stroke (I60–I69), CVD (including CHD and stroke), intracerebral hemorrhage (I61), and ischemic stroke (I63). The Hisayama Study reported that concordance between causes of death in death certificates and those in autopsy reports were 0.84 for stroke and 0.66 for CHD [8]. A self-administered questionnaire assessed sociodemographic information, smoking and alcohol-drinking status, exercise/sports activities, and self-reported past histories of hypertension and diabetes.

  • The ratio of serum eicosapentaenoic acid to arachidonic acid and risk of cancer death in a Japanese community: The Hisayama Study

    2017, Journal of Epidemiology
    Citation Excerpt :

    When a subject died, we collected all medical information related to his/her illness and death, including hospital charts, physicians' records, and death certificates. Moreover, an autopsy was performed in the Department of Pathology at Kyushu University, if consent for an autopsy was obtained.31,32 All subjects were followed up completely until the end of the survey.

  • Associations of Walking Speed, Grip Strength, and Standing Balance With Total and Cause-Specific Mortality in a General Population of Japanese Elders

    2016, Journal of the American Medical Directors Association
    Citation Excerpt :

    Use of death certificates to classify major causes of death may lead to misclassification. However, this limitation is not unique to the present study, and the use of death certificates for this purpose was reported to be accurate in Japan.15,16 Walking speed is an established indicator of overall gait performance.

View all citing articles on Scopus
View full text