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Validity of cerebrovascular mortality rates
1Department of Pathology, Wellington School of Medicine, New Zealand.
Insights
Cerebrovascular disease (CVD) mortality data is unreliable for scientific research due to significant diagnostic errors. These inaccuracies limit its use in understanding CVD and coronary heart disease risk factors.
Area of Science:
- Epidemiology
- Public Health Statistics
- Cardiovascular Research
Background:
- Cerebrovascular disease (CVD) mortality rates are increasingly correlated with coronary heart disease risk factors.
- Existing vital statistics for CVD and coronary heart disease share similar general defects.
- Diagnostic accuracy for cerebrovascular disease subdivisions, including stroke, is notably poorer than for coronary heart disease.
Purpose of the Study:
- To evaluate the scientific validity of cerebrovascular disease mortality rates.
- To assess the suitability of clinical CVD as a surrogate for atherosclerosis severity in epidemiologic studies.
Main Methods:
- Analysis of national and regional vital statistics related to cerebrovascular disease mortality.
- Critique of diagnostic criteria and reporting for cerebrovascular disease and stroke.
- Evaluation of the utility of clinical cerebrovascular disease as an indicator of atherosclerosis severity.
Main Results:
- Cerebrovascular disease mortality statistics are too inaccurate for reliable scientific application.
- Diagnostic errors in CVD subdivisions are substantial, rendering national/regional data questionable.
- Clinical CVD serves as an inappropriate and imprecise surrogate for atherosclerosis severity.
- Epidemiologic studies face indeterminate data overlap due to the limitations of clinical CVD as a measure.
Conclusions:
- Cerebrovascular disease mortality rates, as currently recorded, are not scientifically valid.
- The use of clinical CVD as a proxy for atherosclerosis severity is problematic for epidemiologic research.
- Improved diagnostic accuracy and data collection are crucial for accurate cerebrovascular disease research.
Abstract:
Cerebrovascular disease (CVD) mortality rates are being increasingly used to establish a relationship with coronary heart disease risk factors. Cerebrovascular mortality rates suffer from the same general defects as coronary heart disease mortality rates but with greater diagnostic error in regard to subdivisions of CVD or stroke. These vital statistics, whether national or regional, are too inaccurate for scientific use and cannot be regarded as representing true mortality rates for any country. Moreover, clinical CVD is an inappropriate surrogate for severity of atherosclerosis, providing inexact data and allowing indeterminate overlap in epidemiologic studies.