TY - JOUR TI - European study of the certification and coding of causes of death of six clinical case histories of diabetic patients. EURODIAB Subarea C Study Group AU - Balkau, B AU - Jougla, E AU - Papoz, L T2 - International Journal of Epidemiology AB - This study was designed to investigate the large differences in diabetes mortality rates in Europe. In each of the participating countries (France, Germany, The Netherlands, Northern Ireland-UK, Republic of Ireland, Romania, Scotland-UK, Switzerland) a random sample of certifying physicians was asked to certify the causes of death of six case histories which described the deaths of diabetic patients; the responses from an average of 220 physicians per country were analysed. These registered causes were then coded nationally and the underlying cause was compared with that following a central recoding. Overall 28% of the physicians surveyed recorded diabetes on the death certificate as the underlying cause of death--France was 25% below this overall average and Germany 21% above. The national coding of diabetes as the underlying cause of death differed from the central recoding with a comparative undercoding of almost 40% in Romania, 30% in Northern Ireland and 25% in Switzerland; in contrast, there was an overcoding of diabetes by 80% in The Netherlands and 60% in the Republic of Ireland. After adjusting for central recoding, in part an adjustment for certification habits, the national coding from this simulation study was able to explain 35% of the variation in the diabetes mortality rates. With such differences in the coding of diabetes, the currently published mortality rates for diabetes are not directly comparable between European countries; some suggestions are made for the reduction of the intercountry differences in the collection and analysis of mortality data for diabetes. CN - 0000 DA - 1993/02// PY - 1993 DP - NCBI PubMed VL - 22 IS - 1 SP - 116 EP - 126 J2 - Int J Epidemiol SN - 0300-5771 UR - http://www.ncbi.nlm.nih.gov/pubmed/8449631 Y2 - 2012/06/27/13:18:59 KW - Abstracting and Indexing as Topic KW - Adolescent KW - Aged KW - Aged, 80 and over KW - Diabetes Mellitus KW - Europe KW - Female KW - Humans KW - Male KW - Middle Aged KW - Questionnaires KW - Registries ER -