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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Agreement on cause of death between proxies, death certificates, and clinician adjudicators in the reasons for geographic and racial differences in stroke (REGARDS) study
American Journal of Epidemiology, Volume 173, No. 11, Year 2011
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Description
Death certificates may lack accuracy and misclassify the cause of death. The validity of proxy-reported cause of death is not well established. The authors examined death records on 336 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a national cohort study of 30,239 community-dwelling US adults (2003-2010). Trained experts used study data, medical records, death certificates, and proxy reports to adjudicate causes of death. The authors computed agreement on cause of death from the death certificate, proxy, and adjudication, as well as sensitivity and specificity for certain diseases. Adjudicated cause of death had a higher rate of agreement with proxy reports (73%; Cohen's kappa (κ) statistic = 0.69) than with death certificates (61%; κ = 0.54). The agreement between proxy reports and adjudicators was better than agreement with death certificates for all disease-specific causes of death. Using the adjudicator assessments as the "gold standard," for disease-specific causes of death, proxy reports had similar or higher specificity and higher sensitivity (sensitivity = 50%-89%) than death certificates (sensitivity = 31%-81%). Proxy reports may be more concordant with adjudicated causes of death than with the causes of death listed on death certificates. In many settings, proxy reports may represent a better strategy for determining cause of death than reliance on death certificates. © 2011 The Author.
Authors & Co-Authors
Shuaib, Faisal Mohammed B.
United States, Birmingham
The University of Alabama at Birmingham
Howard, Virginia J.
United States, Birmingham
The University of Alabama at Birmingham
Roth, David L.
United States, Birmingham
The University of Alabama at Birmingham
Prineas, Ronald J.
United States, Winston Salem
Wake Forest University
Safford, Monika M.
United States, Birmingham
The University of Alabama at Birmingham
Statistics
Citations: 67
Authors: 5
Affiliations: 2
Identifiers
Doi:
10.1093/aje/kwr033
ISSN:
00029262
Research Areas
Noncommunicable Diseases
Study Design
Cohort Study
Study Approach
Quantitative