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Physician's manual reporting underestimates mortality: evidence from a population-based HIV/AIDS treatment program
Christopher G Au-Yeung1, Aranka Anema, Keith Chan
1British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
BMC Public Health
|October 27, 2010
Summary
Manual death reporting significantly underestimates mortality in cohort studies. Electronic vital event registries capture more deaths, crucial for accurate therapeutic intervention evaluation.
Area of Science:
- Clinical epidemiology
- Public health surveillance
Background:
- Mortality estimates in research often rely on physician reports or vital event registries.
- Manual methods may underreport deaths compared to electronic vital event registry data.
Purpose of the Study:
- To compare the accuracy of manual death reporting versus electronic vital event registry data.
- To identify factors influencing manual death underreporting in a cohort study.
Main Methods:
- Retrospective analysis of an observational cohort (n=3,116) initiating highly-active antiretroviral therapy (HAART).
- Compared deaths identified by manual physician reports versus annual electronic record linkages with a vital event registry.
- Used multivariate logistic regression to identify predictors of manual death reporting.
Main Results:
- 622 deaths (20.0%) occurred during follow-up.
- Manual reporting identified 60.6% of deaths; electronic linkages captured 96.1%.
- Lower CD4 count, higher viral load, injection drug use, and care by HIV-experienced physicians predicted manual underreporting.
Conclusions:
- Sole reliance on manual death ascertainment significantly underestimates mortality.
- Underreporting introduces bias in evaluating population-level therapeutic intervention impacts.
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