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Invalid certification of young deaths.

R Sunderland, E P Sunderland

Archives of Disease in Childhood

|November 1, 1983

Summary

Necropsy and death certificate data for Sheffield children revealed significant discrepancies in recorded causes of death. These inaccuracies, particularly in infant deaths, highlight issues in death certification practices.

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Area of Science:

* Forensic Pathology
* Medical Record Analysis
* Public Health Surveillance

Background:

* Accurate death certification is crucial for epidemiological studies and public health.
* Previous studies suggest potential inaccuracies in death certificates, particularly for infant mortality.

Purpose of the Study:

* To assess the accuracy of death certificates by comparing them with necropsy reports for children in Sheffield.
* To identify patterns and factors associated with discrepancies in cause of death reporting.

Main Methods:

* Retrospective analysis of 3928 necropsy reports and corresponding death certificates for children who died between 1947 and 1979 in Sheffield.
* Comparison of underlying causes of death recorded in necropsy reports versus death certificates.
* Statistical analysis to identify factors influencing discrepancy rates.

Main Results:

* Significant discrepancies in the underlying cause of death were found in 15% of cases.
* Common errors included incorrect placement of the cause of death on the certificate and misrepresentation of disease categories (e.g., overrepresentation of infections, underrepresentation of malformations).
* Discrepancies were more prevalent in younger children and hospital deaths.

Conclusions:

* Death certification practices for children during the study period exhibited notable inaccuracies, impacting the reliability of mortality statistics.
* The findings suggest a need for improved training and standardization in death certification.
* Historical diagnoses like 'convulsions' may be precursors to modern Sudden Infant Death Syndrome (SIDS) diagnoses.

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