ACCURACY OF ASTHMA STATISTICS FROM DEATH CERTIFICATES IN SOUTH-AUSTRALIA

Objective: To assess the accuracy of asthma statistics from death certificates in South Australia. Design: Comparison of death certificate coding with expert panel assessments of causes of death after interviews with certifying doctors, regular medical practitioners and close acquaintances of the deceased. Subjects: 261 subjects for whom the term "asthma", "asthmatic" or "asthmaticus" was recorded in Part I or Part II of death certificates lodged in the 24-month period from May 1988. Main outcome measures: Sensitivity, specificity and predictive value of death certificate coding, with expert panel assessments as the reference standard. Results: About 95% of deaths assessed as definitely due to asthma were so coded from death certificates, but only 69% of deaths assessed by the panel as not due to asthma were coded to a "non-asthmatic" cause. Of the 129 deaths coded to asthma, the percentage assessed as definitely or likely to be due to asthma was 56%. For ages under 65 years, this figure was 84% compared with only 38% for older subjects. Conclusion: The accuracy of death certificate data on asthma for the age group 65 years and over would be too low at present for most epidemiological purposes.