Death certification by British doctors: a demographic analysis

Regional differences in mortality from cardiovascular diseases, respiratory diseases, strokes, and other causes have been observed in England and Wales. To determine to what extent the death certification practices of doctors influence these variations, we surveyed 123 British general practitioners and housemen. Each doctor completed death certificates based on fictitious case histories. We found that diagnostic groupings did not vary significantly according to the doctors' region, type of practice, place of medical training, sex, or year of qualification. Doctors qualifying before 1955, however, appeared more inclined than their younger colleagues to list stomach cancer on the death certificate.