Overreporting of Deaths From Coronary Heart Disease in New York City Hospitals, 2003 - Preventing Chronic Disease: May 2010: 09_0086

ORIGINAL RESEARCH
Overreporting of Deaths From Coronary Heart Disease in New York City Hospitals, 2003

TABLE OF CONTENTS

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Reena Agarwal, MD, MPH; Jennifer M. Norton, PhD; Kevin Konty, MS, MA; Regina Zimmerman, PhD, MPH; Maleeka Glover, ScD; Akaki Lekiachvili, PhD; Henraya McGruder, PhD; Ann Malarcher, PhD; Michele Casper, PhD; George A. Mensah, MD; Lorna Thorpe, PhD
Suggested citation for this article: Agarwal R, Norton JM, Konty K, Zimmerman R, Glover M, Lekiachvili A, et al. Overreporting of deaths from coronary heart disease in New York City hospitals, 2003. Prev Chronic Dis 2010;7(3).
http://www.cdc.gov/pcd/issues/2010/may/09_0086.htm. Accessed [date].

Abstract
Introduction
New York City has one of the highest reported death rates from coronary heart disease in the United States. We sought to measure the accuracy of this rate by examining death certificates.

Methods
We conducted a cross-sectional validation study by using a random sample of death certificates that recorded in-hospital deaths in New York City from January through June 2003, stratified by neighborhoods with low, medium, and high coronary heart disease death rates. We abstracted data from hospital records, and an independent, blinded medical team reviewed these data to validate cause of death. We computed a comparability ratio (coronary heart disease deaths recorded on death certificates divided by validated coronary heart disease deaths) to quantify agreement between death certificate determination and clinical judgment.

Results
Of 491 sampled death certificates for in-hospital deaths, medical charts were abstracted and reviewed by the expert panel for 444 (90%). The comparability ratio for coronary heart disease deaths among decedents aged 35 to 74 years was 1.51, indicating that death certificates overestimated coronary heart disease deaths in this age group by 51%. The comparability ratio increased with age to 1.94 for decedents aged 75 to 84 years and to 2.37 for decedents aged 85 years or older.

Conclusion
Coronary heart disease appears to be substantially overreported as a cause of death in New York City among in-hospital deaths.

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Preventing Chronic Disease: May 2010: 09_0086